Intradialytic Hypoxemia in Chronic Hemodialysis Patients

Blood Purification
Israel CamposPeter Kotanko

Abstract

When kidney failure occurs, patients are at risk for fluid overload states, which can cause pulmonary edema, pleural effusions, and upper airway obstruction. Kidney disease is also associated with impaired respiratory function, as in central sleep apnea or chronic obstructive pulmonary disease. Hence, respiratory and renal diseases are frequently coexisting. Hypoxemia is the terminal pathway of a multitude of respiratory pathologies. The measurement of oxygen saturation (SO2) is a basic and commonly used tool in clinical practice. Both arterial oxygen saturation (SaO2) and central venous oxygen saturation (ScvO2) can be easily obtained in hemodialysis (HD) patients, SaO2 from an arteriovenous access and ScvO2 from a central catheter. Here, we give a brief overview of the anatomy and physiology of the respiratory system, and the different technologies that are currently available to measure oxygen status in dialysis patients. We then focus on literature regarding intradialytic SaO2 and ScvO2. Lastly, we present clinical vignettes of intradialytic drops in SaO2 and ScvO2 in association with different symptoms and clinical scenarios with an emphasis on the pathophysiology of these cases. Given the fact that in the general populati...Continue Reading

Citations

Feb 27, 2018·Blood Purification·Frank M van der SandeJeroen P Kooman
Feb 13, 2018·Seminars in Dialysis·Clare MacEwenChristopher Pugh
Nov 18, 2017·Seminars in Dialysis·Qi Qian
Dec 1, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Anna Meyring-WöstenPeter Kotanko
Dec 19, 2018·Physiological Measurement·Frida SandbergBo Olde
Jun 7, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Weinan YuWen Hu
Jul 14, 2020·Current Opinion in Nephrology and Hypertension·Daniel L Edmonston, Matthew A Sparks
Sep 21, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Hanjie ZhangPeter Kotanko
Jan 24, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Manisha JhambMark Unruh
Apr 21, 2018·Seminars in Dialysis·Jeroen P KoomanPeter Kotanko
Dec 6, 2018·Seminars in Dialysis·Clare MacEwenChristopher Pugh
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Nov 21, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Cécile CouchoudGuillaume Jean
Nov 10, 2020·KI Reports·Bernard CanaudPeter Kotanko
Jan 29, 2021·Journal of Applied Physiology·Scott McGuireGordon McGregor
Jun 8, 2021·Clinical Kidney Journal·Priscila PreciadoPeter Kotanko
Sep 19, 2021·Seminars in Dialysis·Francini Porcher AndradePaula Maria Eidt Rovedder

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