Hemodynamic studies, acid-base status and osmolality in different hemodialysis procedures.
Three patients on maintenance dialysis were each treated with three different procedures: A) twenty-liter recirculation dialysis with bicarbonate buffering, B) recirculation-adsorption dialysis and C) single-pass dialysis. Hemodynamic parameters were measured invasively and procedures A, B and C were compared for each patient. In this intraindividual comparative study, the authors attempted to establish a relationship between the varying hemodynamic parameters and the changes in osmolality and acid-base status. There were indications of some causal relationship to circulatory stability: in A and B, there were peripheral resistance increases of 24.5% and 38.4%, respectively, with stable circulation; in C, there was a 6.1% increase and unstable circulation. Additionally, the influence of acidosis is shown in B, with disproportionately strong reductions of cardiac output (21.9%) and pulmonary artery pressure (44.9%); In spite of a decrease of osmolality (A: 15.6 mOsm/L), stable circulation could be achieved if the peripheral resistance was substantially increased and acid-base status was equalized.
D000136:Acid-Base Equilibrium; D000327:Adsorption; D001639:Bicarbonates; D001794:Blood Pressure; D002021:Buffers; D002302:Cardiac Output; D002496:Central Venous Pressure; D005374:Filtration / Q000379:methods; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D009994:Osmolar Concentration; D006435:Renal Dialysis / Q000379:methods*; D013318:Stroke Volume; D014462:Ultrafiltration / Q000379:methods; D014655:Vascular Resistance
D001639:Bicarbonates; D002021:Buffers