Physiologic approach to dialysis-induced hypoxemia. Effects of dialyzer material and dialysate composition

Nephron
H IgarashiM Arakawa

Abstract

This study was undertaken to evaluate the effects of membrane-related complement activation and dialysate composition on dialysis-associated hypoxemia. Seven chronic hemodialysis patients were hemodialyzed 3 times sequentially with the following three combinations; Cuprophan membrane with acetate dialysate, polymethylmethacrylate (PMMA) membrane with acetate dialysate, and PMMA membrane with bicarbonate dialysate. During dialysis with acetate dialysate, the pulmonary diffusing capacity (DLco) at 30 min after the start of dialysis was decreased to 88% (p less than 0.01) of the predialysis value with PMMA and to 79% (p less than 0.01) with Cuprophan, and the degree of DLco on PMMA membrane was different from that on Cuprophan (p less than 0.01). The degree of leukopenia with PMMA was less than that with Cuprophan. However, the fall in DLco did not alter the alveolar-arterial O2 tension gradient. Although the changes in transcutaneous PO2 (tcPO2) were not constant in all three combinations, a distinct fall in tcPO2 was observed in the first half of dialysis with acetate dialysate. During dialysis with acetate dialysate but not with bicarbonate, the extracorporeal dialyzer removed an average of 60 ml/min of CO2, and the respiratory...Continue Reading

Citations

Sep 17, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ji-Young ChoiYong-Lim Kim
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
Apr 1, 1992·Kidney International·T SymrengV S Lim
Mar 5, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Anna Meyring-WöstenPeter Kotanko
Jun 30, 2000·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M A MungerE H Marshall
Oct 6, 2004·Seminars in Dialysis·Allessandro Bellucci
Jul 9, 2004·Advances in Chronic Kidney Disease·Francis Dumler, Peter A McCullough

Related Concepts

Cuprammonium cellulose
Acetic Acids
Anoxemia
Carbonic Acid Ions
Carbon Dioxide
Alphacel
Complement Activation
Hemodialysis
Kidney Failure, Chronic
Leukopenia

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