Document Detail


Impaired peripheral micro- and macrocirculation during hemodialysis in uremic patients.
MedLine Citation:
PMID:  20671655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
P Santesson; A Danielsson; I Iseda; U Adamson; P E Lins; G Jörneskog
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2010-07-30     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  362-70     Citation Subset:  IM    
Affiliation:
Divisions of Medicine, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. gun.jorneskog@ds.se
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MeSH Terms
Descriptor/Qualifier:
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:
0/Hemoglobins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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