PMID: 7165555Nov 1, 1982

Pathogenesis of dialysis-induced hypoxemia

Artificial Organs
W D DavidsonK Wasserman

Abstract

Patients undergoing hemodialysis with acetate-containing dialysis solutions develop hypoxemia. To determine the cause of the hypoxemia, we studied and compared the ventilatory, gas-exchange and blood-gas responses in chronic renal failure patients undergoing hemodialysis with acetate and bicarbonate dialysis solutions. Seven stable chronic dialysis patients were dialyzed against acetate and bicarbonate solutions in a random order. Dialysis was carried out using a 1.5 m2 hollow fiber dialyzer at a blood flow rate of 200 ml/min and a dialysate flow rate of 500 ml/min. During acetate dialysis, PaO2 fell within 15 minutes from a mean control predialysis concentration of 84 = 6 (SEM) mmHg to a mean of 70 +/- 7.5 mmHg (P less than 0.05), and remained low throughout the study. PaO2 did not change significantly during bicarbonate dialysis. Total ventilation fell from a predialysis level of 7.2 +/- 0.7 L/min to 5.7 +/- 0.6 L/min within 15 minutes (P less than 0.05). PaCO2 was not significantly changed from predialysis levels with either acetate or bicarbonate dialysis. Measurement of blood concentration of CO2 and bicarbonate across the dialyzer indicated that the total CO2 loss (as CO2 and bicarbonate) through the dialyzer was 3 millim...Continue Reading

References

Feb 1, 1977·Anesthesiology·T KolobowJ E Pierce
Oct 20, 1977·The New England Journal of Medicine·N M AurigemmaE G Lowrie
Nov 1, 1978·The Journal of Clinical Investigation·C S Liang, J M Lowenstein
Jan 1, 1978·Nephron·N TolchinE J Lewis
Apr 7, 1977·The New England Journal of Medicine·P R CraddockH S Jacob
Jul 9, 1981·The New England Journal of Medicine·M J DolanK Wasserman
Apr 1, 1982·Kidney International·R L WathenL C Meyer

Citations

Jun 1, 1990·Artificial Organs·M MorosettiC U Casciani
Apr 1, 1988·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M CardosoL Lapierre
Jan 1, 1987·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S M Diamond, W L Henrich
May 1, 1983·Kidney International·W A De BackerM E De Broe

Related Concepts

Acetic Acids
Anoxemia
Carbonic Acid Ions
Blood Gas Analysis
Forced Expiratory Flow Rates
Hemodialysis
Kidney Failure, Chronic
Vinegar

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