title: Factors affecting cerebral oxygenation in hemodialysis patients: cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus.
abstract: BACKGROUND
  Patients undergoing hemodialysis (HD) often develop cerebral disease complications. Furthermore, cerebral regional saturation of oxygen (rSO2) was previously reported to be significantly lower in HD patients than in healthy subjects. We aimed to identify the factors affecting the cerebral rSO2 in HD patients.
  
  
  METHODS
  Fifty-four HD patients (38 men and 16 women; mean age, 67.7 ± 1.2 years, HD duration, 6.5 ± 1.9 years) were recruited. Cerebral rSO2 was monitored at the forehead before HD using an INVOS 5100C (Covidien Japan, Tokyo, Japan).
  
  
  RESULTS
  The rSO2 levels were significantly lower in HD patients compared with healthy controls (49.5 ± 1.7% vs. 68.9 ± 1.6%, p <0.001). Multiple regression analysis showed that cerebral rSO2 independently associated with pH (standardized coefficient: -0.35), HD duration (standardized coefficient: -0.33), and serum albumin concentration (standardized coefficient: 0.28). Furthermore, the rSO2 was significantly lower in HD patients with diabetes mellitus (DM), compared with patients without DM (46.8 ± 1.7% vs. 52.1 ± 1.8%, p <0.05).
  
  
  CONCLUSIONS
  In HD patients, cerebral rSO2 was affected by multiple factors, including pH, HD duration, and serum albumin concentration. Furthermore, this is the first report describing significantly lower levels of rSO2 in HD patients with DM than in those without DM.
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Ito
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan; Department of Internal Medicine, Nishikawa Town Hospital, Yamagata, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Ookawara
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Goto
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Miyazawa
authors.affiliation: Division of Endocrinology and Metabolism, Department of Integrated Medicine Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Hodaka
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Kitano
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Shindo
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kaku
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Division of Endocrinology and Metabolism, Department of Integrated Medicine Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Hoshino
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Nabata
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Honami
authors.initials: H
authors.lastname: Mori
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Yoshida
authors.affiliation: Division of Endocrinology and Metabolism, Department of Integrated Medicine Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kakei
authors.affiliation: Division of Nephrology, Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tabei
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D012709:Serum Albumin; D010100:Oxygen