Haemodialysis decreases finger pressures independent of artificial kidney blood flow.
BACKGROUND
During haemodialysis, some patients experience intensification of symptoms of haemodialysis access-induced distal ischaemia. Aim of this study is to compare the effects of two different regimens of arterial blood flow in patients with an arteriovenous access.


METHODS
A questionnaire identified 10 patients that subjectively experienced ischaemic symptoms during haemodialysis. Systolic blood pressure, heart rate, finger pressure (P(dig)), finger temperature (T(dig)), oxygen saturation and ischaemic scores were monitored during two different arterial blood flow dialysis sessions.


RESULTS
Before dialysis, P(dig) and T(dig) of the arteriovenous access hand were significantly lower compared with the other hand. Haemodialysis induced a drop of P(dig) in both hands. All changes in P(dig) occurred independent of the artificial kidney's blood flow level.


CONCLUSIONS
Systemic hypotension following onset of haemodialysis further intensifies an already diminished hand perfusion. Measures preventing dialytic hypotension will likely attenuate symptoms associated with haemodialysis access-induced distal ischaemia during haemodialysis.
Van Hoek
Frank
F
Departments of Surgery, Máxima Medical Center-Veldhoven, PO box 7777, 5500 MB Veldhoven, The Netherlands.
Scheltinga
Marc R
MR
Houterman
Saskia
S
Beerenhout
Charles H
CH
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001794:Blood Pressure; D001831:Body Temperature; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006339:Heart Rate; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D007511:Ischemia / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010100:Oxygen / Q000097:blood; D012039:Regional Blood Flow; D012079:Renal Circulation; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
D010100:Oxygen