Abstract |
HD tissue hypoxia associates with organ dysfunctions. OER, the ratio between SaO2 and central-venous-oxygen-saturation, could estimate oxygen requirements during sessions, but no data are available. We evaluated OER behavior in 20 HD patients with permanent central venous catheter (CVC) as vascular access. Pre-HD OER (33.6 ± 1.4%; M ± SE) was higher than normal (range 20-30%). HD sessions increased OER to 39.2 ± 1.5% (M ± SE; p < 0.05) by 30' and to 47.4 ± 1.5% (M ± SE; p < 0.001) by end of treatment (delta 40%). During HD sessions of the long and short interdialytic intervals, OER values overlapped, suggesting no influence of patient's hydration status shifts. OER increased (p < 0.05) after 30' of isolated HD (zero ultrafiltration), but not during isolated ultrafiltration (zero dialysate flow), suggesting a role for blood-membrane- dialysate interaction, independent of volume reduction. In ten patients, individual variability of pre-HD OER was low and repeatable (maximum calculated difference over time 6.6%), and negatively correlated with HD-induced OER increments (r = 0.860; p < 0.005), suggesting a decline in the adaptive response along with resting OER increments. In 30 prevalent patients, adjusted multivariate analysis showed that pre-HD OER (HR = 0.88, CI 0.79-0.99, p = 0.028) and percent HD-induced OER (HR = 1.04, CI 1.01-1.08, p = 0.015) were both associated with mortality, with threshold values respectively <32% and >40%. In HD patients with CVC as vascular access, OER is a cheap, easily measurable and repeatable parameter useful to assess intradialytic hypoxia, and a potential biomarker of HD related stress and morbidity, helpful to recognize patients at increased risk of mortality.
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Authors | Silverio Rotondi, Lida Tartaglione, Maria Luisa Muci, Alessio Farcomeni, Marzia Pasquali, Sandro Mazzaferro |
Journal | Scientific reports
(Sci Rep)
Vol. 8
Issue 1
Pg. 5655
(04 04 2018)
ISSN: 2045-2322 [Electronic] England |
PMID | 29618823
(Publication Type: Clinical Trial, Journal Article, Observational Study)
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Chemical References |
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Topics |
- Aged
- Female
- Humans
- Hypoxia
(etiology, metabolism, mortality, physiopathology)
- Kidney Failure, Chronic
(metabolism, therapy)
- Male
- Oxygen
(metabolism)
- Pilot Projects
- Prognosis
- Prospective Studies
- Renal Dialysis
(adverse effects)
- Survival Rate
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