BACKGROUND/AIMS: Patients undergoing hemodialysis (HD) have higher occurrence rates of cerebral diseases, including uremic encephalopathy, cognitive impairment, dementia, and cerebrovascular disease, than the general population. During HD, ultrafiltration is performed to maintain an adequate fluid condition and is associated with subsequent blood volume (BV) reduction. We aimed to (1) monitor changes in cerebral oxygenation and BV reduction during HD, and (2) clarify the mechanism that influences cerebral oxygenation in HD patients. METHODS: Eighteen HD patients and 12 healthy controls were recruited. Regional saturation of oxygen (rSO2) was continuously monitored in the frontal cortex using INVOS 5100C before, during, and after HD, and in healthy controls. Relative change in BV (%ΔBV) was simultaneously monitored during HD using a BV monitor. RESULTS: Before HD, patients had significantly lower rSO2 values than controls (56.1 ± 1.4 vs. 70.4 ± 2.5%, p < 0.001). Although %ΔBV significantly decreased from 20 min to the end of HD (20 min: -3.3 ± 0.3%, p < 0.05; end of HD: -12.0 ± 1.0%, p < 0.01), changes in rSO2 values during HD were not significant. No relationship existed between rSO2 values and blood pressure levels, hemoglobin levels, oxygen pressure, HCO3(- ), oxygen saturation, and arterial O2 content before and after HD. Furthermore, changes in rSO2 were not correlated with changes in these parameters. CONCLUSION: rSO2 values before HD were significantly lower in HD patients than in healthy controls. rSO2 values were maintained during HD and were not influenced by BV reduction.
BACKGROUND/AIMS: Patients undergoing hemodialysis (HD) have higher occurrence rates of cerebral diseases, including uremic encephalopathy, cognitive impairment, dementia, and cerebrovascular disease, than the general population. During HD, ultrafiltration is performed to maintain an adequate fluid condition and is associated with subsequent blood volume (BV) reduction. We aimed to (1) monitor changes in cerebral oxygenation and BV reduction during HD, and (2) clarify the mechanism that influences cerebral oxygenation in HDpatients. METHODS: Eighteen HDpatients and 12 healthy controls were recruited. Regional saturation of oxygen (rSO2) was continuously monitored in the frontal cortex using INVOS 5100C before, during, and after HD, and in healthy controls. Relative change in BV (%ΔBV) was simultaneously monitored during HD using a BV monitor. RESULTS: Before HD, patients had significantly lower rSO2 values than controls (56.1 ± 1.4 vs. 70.4 ± 2.5%, p < 0.001). Although %ΔBV significantly decreased from 20 min to the end of HD (20 min: -3.3 ± 0.3%, p < 0.05; end of HD: -12.0 ± 1.0%, p < 0.01), changes in rSO2 values during HD were not significant. No relationship existed between rSO2 values and blood pressure levels, hemoglobin levels, oxygen pressure, HCO3(- ), oxygen saturation, and arterial O2 content before and after HD. Furthermore, changes in rSO2 were not correlated with changes in these parameters. CONCLUSION:rSO2 values before HD were significantly lower in HDpatients than in healthy controls. rSO2 values were maintained during HD and were not influenced by BV reduction.
Authors: Harmke A Polinder-Bos; David Vállez García; Johanna Kuipers; Jan Willem J Elting; Marcel J H Aries; Wim P Krijnen; Henk Groen; Antoon T M Willemsen; Peter J van Laar; Fijanne Strijkert; Gert Luurtsema; Riemer H J A Slart; Ralf Westerhuis; Ron T Gansevoort; Carlo A J M Gaillard; Casper F M Franssen Journal: J Am Soc Nephrol Date: 2018-03-01 Impact factor: 10.121
Authors: Harmke A Polinder-Bos; Jan Willem J Elting; Marcel Jh Aries; David Vállez García; Antoon Tm Willemsen; Peter J van Laar; Johanna Kuipers; Wim P Krijnen; Riemer Hja Slart; Gert Luurtsema; Ralf Westerhuis; Ron T Gansevoort; Carlo Ajm Gaillard; Casper Fm Franssen Journal: J Cereb Blood Flow Metab Date: 2018-12-12 Impact factor: 6.200