Cerebral oxygenation changes in response to post-hemodialysis standing

Imai, Sojiro; Ookawara, Susumu; K, Ito; Hattori, Takashi; Fueki, Mariko; Iguchi, Miho; Kiryu, Satoshi; Sanayama, Hidenori; Kakei, Masafumi; Tabei, Kaoru; Morishita, Yoshiyuki

doi:10.1007/s10047-022-01343-2

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Low tissue oxygenation may have negative influence on HD patients. Anemic conditions, overhydrated status, and hypotension could induce organ hypoxia in the brain or intra-abdominal organs [20][21][22][26][27][28] . Furthermore, cerebral oxygenation impairment could be related to cognitive impairment 29,30 , and access hand rSO 2 was reportedly associated with grip strength 31 .…”

Section: Discussionmentioning

confidence: 99%

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Sugiyama

K²,

Ookawara³

et al. 2023

Sci Rep

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In hemodialysis (HD) patients with arteriovenous fistula (AVF), changes in systemic or peripheral tissue circulation occur non-physiologically via the presence of AVF; however, associations between blood flow and tissue oxygenation in the brain and access hand are uncertain. In this study, 85 HD patients with AVF were included and evaluated for changes in flow volume (FV) and regional oxygen saturation (rSO2) in the brain and hands with AVF before and after percutaneous transluminal angioplasty (PTA). Furthermore, we evaluated the factors that determine access hand rSO2 without stenosis after PTA. Brachial arterial FV increased after PTA (p < 0.001), and carotid FV decreased (p = 0.008). Access hand rSO2 significantly decreased after PTA (p < 0.001), but cerebral rSO2 did not significantly change (p = 0.317). In multivariable linear regression analysis of factors associated with access hand rSO2, serum creatinine (standardized coefficient: 0.296) and hemoglobin (standardized coefficient: 0.249) were extracted as independent factors for access hand rSO2. In conclusion, a decrease in access hand oxygenation and maintenance of cerebral oxygenation were observed throughout PTA. To maintain access hand oxygenation, it is important to adequately manage Hb level and maintain muscle mass, in addition to having an AVF with appropriate blood flow.

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Section: Discussionmentioning

confidence: 99%

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Sugiyama

K²,

Ookawara³

et al. 2023

Sci Rep

Self Cite

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Effects to cerebral oxygenation by arteriovenous fistula creation in patients with chronic kidney disease

Mutsuyoshi,

Ito,

Ookawara

et al. 2024

J Vasc Access

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Background: Vascular access, including arteriovenous fistula (AVF), is essential in patients undergoing hemodialysis (HD). However, the presence of AVF is non-physiological in humans and could pose a burden to the systemic circulation or tissue microcirculation, potentially affecting tissue oxygenation, including in the brain. Recently, near-infrared spectroscopy has been used to measure regional oxygen saturation (rSO2) as a marker of cerebral oxygenation in various settings, including in patients undergoing HD. Thus far, no studies have reported changes in cerebral rSO2 before and after AVF creation. This study aimed to monitor the differences in cerebral oxygenation before and after AVF creation and to clarify the clinical factors affecting the changes in cerebral rSO2. Methods: Forty-eight patients (34 men, 14 women) with chronic kidney disease (CKD) who were not undergoing dialysis and newly created AVF were recruited. Cerebral rSO2 values before and after AVF creation were evaluated using near-infrared spectroscopy (INVOS 5100c). Results: Cerebral rSO2 values were significantly changed from 60.3% ± 7.5% to 58.4% ± 6.8% before and after AVF creation in all patients ( p < 0.001). Cerebral rSO2 were also lower in patients with diabetes mellitus (DM) than in those without DM (57.5 ± 7.1 vs 63.7 ± 6.5, p = 0.003) before surgery; however, no differences of changes in cerebral rSO2 were observed between the two groups after AVF creation. Additionally, multivariate regression analysis identified changes in HR (standardized coefficient: 0.436) as independent factors associated with changes in cerebral rSO2. Conclusion: Surgically created AVF was associated with the deterioration of cerebral rSO2 in patients with CKD not undergoing dialysis. Notably, AVF could cause cerebral hypoxia, and thus further studies are needed to clarify the clinical factors influencing changes in cerebral oxygenation after AVF creation.

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Cerebral oxygenation changes in response to post-hemodialysis standing

Cited by 2 publications

References 30 publications

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis

Effects to cerebral oxygenation by arteriovenous fistula creation in patients with chronic kidney disease

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