Published in

SAGE Publications, The Journal of Vascular Access, 1(18), p. 47-51, 2016

DOI: 10.5301/jva.5000630

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Tissue ischemia worsens during hemodialysis in end-stage renal disease patients

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

BackgroundCognitive deficit is a common problem in end-stage renal disease (ESRD) patients. Ultrafiltration and hemodialysis lead to profound hemodynamic changes. The aim of this pilot study was to describe brain and hand oxygenation values in ESRD patients and their changes during hemodialysis.MethodsTwenty-seven patients treated by chronic hemodialysis and 17 controls patients of the same age were included in the study. Regional saturation of oxygen (SrO2) was measured at the brain frontal lobe and at the hand with dialysis access using the INVOS 5100C. In 17 of ESRD patients, SrO2was also monitored throughout hemodialysis. Finger systolic blood pressure and basic hemodialysis and laboratory data were collected.ResultsDialysis patients had lower brain and also hand SrO2values at rest (51.5 ± 10.9 vs. 68 ± 7%, p<0.0001 and 55 ± 16 vs. 66 ± 8%, p = 0.03, respectively). Both values further decreased during the first 35 minutes of hemodialysis (brain SrO2to 47 ± 8%, p<0.0001 and hand to 45 ± 14%, p<0.0001, respectively). The brain SrO2decrease was related to the ultrafiltration rate, the hand SrO2decrease to the finger pressure and to blood hemoglobin.ConclusionsChronic dialysis patients suffer from tissue ischemia and that even worsens after the beginning of hemodialysis. This observation may contribute to the understanding of cognitive deficit etiology.