Effect of Hemodialysis on Oxygen-Hemoglobin Affinity in Chronic Uremics

Szwed, James J.; Luft, Friedrich C.; Boykin, John R.; Farber, Mark O.; Kleit, Stuart A.

doi:10.1378/chest.66.3.278

Cited by 10 publications

(9 citation statements)

References 18 publications

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“…Contrary to previous assumptions [6][7][8][9][10], this was not reduced by dialysis; rather it increased from 120.5 to 131.7 ml/min/m2. However, one has to take into consideration that two important parameters entering the calculation of oxygen consumption, i.e.…”

Section: Discussioncontrasting

confidence: 99%

“…The magnitude of this change was somewhat smaller than in an earlier study of ours, in which, however, a larger rise in pH was induced [6]. It has been postulated by several authors including our selves that the decrease in Psoiv (indicating an increased affinity of OsHb) could jeopardize tissue oxygenation and that this could be detrimental to patients with cardiac or respiratory insufficiency [6][7][8][9][10], For instance, it has been calculated by Torrance el al. [10] that a rise in pH from 7.39 to 7.49 could result in a 17.9% decrease in oxygen delivery.…”

Section: Discussioncontrasting

confidence: 50%

“…Such a rapid risein blood pH ischaracteristically induced by hemo dialysis. In several studies it has been reasoned that these changes might be potentially hazardous to the patients and that they could partly explain the dialysis disequilibrium syndrome and postdialysis fatigue [6][7][8][9][10]. However, these conclusions were only tentative since several important parameters such as central venous oxygen tension (Pvos) and cardiac output had not been measured directly.…”

Section: Abbreviationsmentioning

confidence: 99%

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Oxygen Consumption during Maintenance Hemodialysis

Blumberg¹,

Keller²

1979

Nephron

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The influence of hemodialysis on oxygen consumption was studied in 15 patients on maintenance dialysis. Red cell 2,3-DPG, P₅₀, an inverse measure of oxygen affinity of hemoglobin, arterial and central venous blood gases and cardiac index were measured. 2,3-DPG remained unchanged, whereas in vivo P₅₀ fell significantly during dialysis due to a rise of pH (Bohr effect). Arterial PO₂ was lower after than before dialysis, but arterial and central venous oxygen saturations did not change significantly. Cardiac index increased from 3.66 to 4.05 liter/min/m². Oxygen consumption rose from 120.5 to 131.7 ml/min/m² (p < 0.05), the rise being accounted for by an increase in cardiac index and by a slight post-dialysis hemoconcentration. However, even correcting for these parameters did not reveal a decrease in oxygen consumption. It is concluded that, contrary to previous assumptions, the hemodialysis-induced rise in pH with its consequent increase of oxygen hemoglobin affinity did not impair oxygen delivery in this group of patients on maintenance dialysis.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 50%

Section: Abbreviationsmentioning

confidence: 99%

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Oxygen Consumption during Maintenance Hemodialysis

Blumberg¹,

Keller²

1979

Nephron

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“…For example, alkalyzating agents which are used in HD (acetate and bicarbonate) may affect H b-02 affinity. While several studies about the effect of acetate HD on H b-02 affinity were reported, the effect of bicarbonate H D has not been well examined [3][4][5][6][7]. Neph rogenic anemia was shown to decrease Hb-02 affinity through an elevation of red blood cell 2,3-diphosphogly cerate (2, [1,2].…”

Section: Introductionmentioning

confidence: 99%

Factors That Affect Oxygen Affinity of Hemoglobin in Chronic Hemodialysis Patients

Ando

Saitō

Takeuchi³

1987

Nephron

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To investigate various factors that possibly affect oxygen affinity of hemoglobin (Hb-O₂ affinity) in chronic hemodialysis (HD) patients, we determined P₅₀ at standard condition (P₅₀std), 2,3-diphosphoglycerate (2,3-DPG) content in red blood cells, serum inorganic phosphorus (S-Pi), Hb, and arterial blood gas analysis in 55 HD patients. P₅₀std in HD patients was higher than that in normal controls (26.6 ± 1.6 vs. 25.4 ± 1.4 mm Hg; p < 0.001). We could find neither an effect of alkalizating agents for HD (acetate vs. bicarbonate) nor an effect of the underlying disease (diabetics vs. nondiabetics) on Hb-O₂ affinity. There were significant positive correlations between P₅₀std and the duration of HD therapy (r = 0.598; p < 0.001) and between P₅₀std and SPi (r = 0.476; p < 0.001), contrasting with the absence of correlation between P₅₀std and Hb. Forward stepwise multiple-regression analysis demonstrated that the duration of HD therapy played the most important roles in determining P₅₀std, followed by SPi and PO₂. These data suggest that the major factor influencing Hb-O₂ affinity in chronic HD therapy is the duration of the therapy and that the minor factors are SPi and PO₂.

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“…Large discrepancies among results of various series seem to be related to the severity of anaemia and variations of the phosphate and plasma pH levels [7,8,[11][12][13][14][15][16][17][18][19]. Large discrepancies among results of various series seem to be related to the severity of anaemia and variations of the phosphate and plasma pH levels [7,8,[11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte organic phosphates and whole blood oxygen affinity in patients on continuous ambulatory peritoneal dialysis

Camus

Rottembourg

Eugene

et al. 1982

Eur J Clin Investigation

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Whole blood oxygen affinity, erythrocyte pH and organic phosphates were studied in five anaemic untransfused patients with end stage renal disease undergoing continuous ambulatory peritoneal dialysis. Decreased whole blood oxygen affinity with increased adenosine triphosphate and normal 2.3 diphosphoglycerate (DPG) values were observed. Normal and stable serum phosphate and permanent mild metabolic acidosis may be important factors contributing to maintain DPG levels within the normal range despite anaemia. Continuous dialysis avoids cyclic fluctuation of blood oxygen affinity as described during and after dialysis sessions in patients on maintenance haemodialysis.

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Effect of Hemodialysis on Oxygen-Hemoglobin Affinity in Chronic Uremics

Cited by 10 publications

References 18 publications

Oxygen Consumption during Maintenance Hemodialysis

Oxygen Consumption during Maintenance Hemodialysis

Factors That Affect Oxygen Affinity of Hemoglobin in Chronic Hemodialysis Patients

Erythrocyte organic phosphates and whole blood oxygen affinity in patients on continuous ambulatory peritoneal dialysis

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