| Splanchnic erythrocyte content decreases during hemodialysis: a new compensatory mechanism for hypovolemia. | |
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MedLine Citation:
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PMID: 9186892 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Splanchnic and splenic erythrocyte volumes decrease during postural changes and exercise to help maintain central blood volume and cardiac output. The contribution of this compensatory mechanism to hemodynamic stability during dialysis has not been studied, however. In 8 ESRD patients, age 51.0 +/- 4.5 years old, we measured changes in the splanchnic/splenic erythrocyte volume during dialysis by tagging the patients' erythrocytes with technetium and following abdominal radioactivity over time. Splanchnic radioactivity decreased to 90.2 +/- 3.8% (mean +/- SEM) of the baseline value after 2 hr of accelerated fluid removal (3.7 +/- 0.4 liters) during dialysis (DUF), while it remained relatively unchanged after two hours of dialysis without fluid removal (DD) [106.5 +/- 2.3%, P (DUF vs. DD) = 0.03]. Splenic radioactivity decreased to 89.2 +/- 5.0% of the initial value during DUF versus 103 +/- 3.8% during DD, but the decrease was noted only during the last 30 minutes of DUF and did not attain statistical significance. Autonomic nervous system integrity was measured by the spontaneous variation of the R-R interval during deep respiration (E/I ratio) and by the Valsalva ratio. The mean E/I and Valsalva ratios in the eight patients were 1.13 +/- 0.03 (+/-SEM) and 1.42 +/- 0.1 respectively, suggesting reasonably adequate autonomic nervous system functioning. The results suggest that contraction of the splanchnic, and possibly the splenic, vascular beds occurs during fluid removal associated with hemodialysis. The resultant addition of erythrocytes to the circulation may help maintain central blood volume and cardiac output. |
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Authors:
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A W Yu; Z M Nawab; W E Barnes; K N Lai; T S Ing; J T Daugirdas |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Kidney international Volume: 51 ISSN: 0085-2538 ISO Abbreviation: Kidney Int. Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-08-18 Completed Date: 1997-08-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1986-90 Citation Subset: IM |
Affiliation:
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Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adaptation, Physiological* Autonomic Nervous System / physiopathology Blood Volume* Erythrocyte Volume* Heart Rate Humans Kidney Failure, Chronic / physiopathology, therapy Male Middle Aged Renal Dialysis* Respiration Splanchnic Circulation* Valsalva Maneuver |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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