| Impaired peripheral micro- and macrocirculation during hemodialysis in uremic patients. | |
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MedLine Citation:
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PMID: 20671655 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Acute hemodynamic changes during hemodialysis may jeopardize the peripheral blood circulation in patients with end-stage renal disease (ESRD). The aim of the present study was to investigate the effects of three consecutive hemodialyses on peripheral micro- and macrocirculation in patients with ESRD. METHODS: Twenty patients with ESRD were investigated, i.e. 10 diabetic and 10 non-diabetic patients, before and during three consecutive hemodialysis during one week. Skin microcirculation was evaluated by transcutaneous oxygen tension (tcPO2) at the chest and foot levels, and maximum microvascular hyperemia (MMH) at the foot by laser Doppler fluxmetry before and during local warming of skin to 44 oC. Macrocirculation was measured by systolic and diastolic arm blood pressure (BP), and by systolic toe BP. RESULTS: MMH, tcPO2 (foot) and tcPO2 (chest) decreased significantly (P=0.01) during hemodialysis, and so did systolic arm BP and toe BP (P=0.02). No significant differences were found between the different hemodialysis days, nor between the diabetic and non-diabetic patients. CONCLUSION: The study shows that peripheral micro- and macrocirculation are impaired during hemodialysis in patients with ESRD. The effects of hemodialysis on peripheral blood perfusion are reproducible, and the same reaction pattern was seen in diabetic and non-diabetic patients. Patients with peripheral arterial occlusive disease seem more susceptible to BP reduction during hemodialysis, and in some patients toe BP and tcPO2 (foot) decreased to levels indicating high risk of gangrene. |
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Authors:
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P Santesson; A Danielsson; I Iseda; U Adamson; P E Lins; G Jörneskog |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: International angiology : a journal of the International Union of Angiology Volume: 29 ISSN: 1827-1839 ISO Abbreviation: Int Angiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-30 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8402693 Medline TA: Int Angiol Country: Italy |
Other Details:
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Languages: eng Pagination: 362-70 Citation Subset: IM |
Affiliation:
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Divisions of Medicine, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. gun.jorneskog@ds.se |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Gas Monitoring, Transcutaneous Blood Pressure* Body Weight Diabetes Mellitus / blood, physiopathology* Female Hemoglobins / metabolism Humans Hyperemia / physiopathology Kidney Failure, Chronic / blood, physiopathology, therapy* Laser-Doppler Flowmetry Male Microcirculation* Middle Aged Renal Dialysis* / adverse effects Reproducibility of Results Skin / blood supply* Time Factors Toes / blood supply* Upper Extremity / blood supply* Uremia / blood, physiopathology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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