Hemodialysis hypoxemia: evaluation of mechanisms utilizing sequential ultrafiltration-dialysis.
We studied the role of blood-dialyzer-membrane interactions in hemodialysis-induced hypoxemia by measuring PaO2 and white blood cell counts during isolated ultrafiltration (UF). These values were compared to those obtained from the same patients during subsequent hemodialysis (HD; utilizing the same dialyzer and membrane). Patients in the UF period displayed no hypoxemia, rather a slight increase in PaO2 (from 82.5 +/- 3.0 to 88.5 +/- 2.0 mm Hg, mean +/- SE, p greater than 0.05). In contrast, these patients displayed significant hypoxemia when HD was imposed (88.5 +/- 2.0-78.0 +/- 1.5 mm Hg, mean +/- SE, p less than 0.02). We suggest that the hypoxemia characteristic of HD initiation is not solely dependent on blood-dialyzer-membrane interactions, but also requires blood-dialysate interactions.
D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000097:blood; D001769:Blood; D001798:Blood Proteins / Q000378:metabolism; D002245:Carbon Dioxide / Q000097:blood; D002712:Chlorides / Q000097:blood; D006801:Humans; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000209:etiology*; D007958:Leukocyte Count; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D006435:Renal Dialysis / Q000009:adverse effects*; D014462:Ultrafiltration
D001639:Bicarbonates; D001798:Blood Proteins; D002712:Chlorides; D002245:Carbon Dioxide; D010100:Oxygen