The Role of the Platelet-Dialysis Membrane Interaction in Thrombus Formation and Blood Loss During Hemodialysis

Lindsay, R. M.; Prentice, C. R. M.; Burton, James; Ferguson, Darren; Kennedy, A. C.

doi:10.1097/00002480-197301900-00085

Cited by 31 publications

(8 citation statements)

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“…7,8 Furthermore, dialyzer membranes may adsorb and retain platelets. [9][10][11][12][13] During any dialysis session, platelet counts may decline transiently but generally rebound and recover following dialysis. 14 The maximum platelet count decline observed with biocompatible membranes has been reported to be around 7% to 9%.…”

Section: Commentmentioning

confidence: 99%

Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia

Kiaii¹,

Djurdjev²,

Farah³

et al. 2011

JAMA

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Section: Commentmentioning

confidence: 99%

Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia

Kiaii¹,

Djurdjev²,

Farah³

et al. 2011

JAMA

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“…However, the amount of blood loss was shown to be minimal, usually not exceeding 50 ml. 20 The accuracy of echocardiography in determining left ventricular volume has been extensively discussed; the consensus now is that determination of stroke volume by echocardiography correlates closely with values obtained by angiography, Fick principle, or dye dilution methods, 2124 provided two conditions are present. The first is a perfect delineation of echocardiographic tracing to allow left ventricular measurement; in this work this was a condition for the selection of patients investigated.…”

Section: Figure 2 Graphs Showing That Total Blood Volume (Tbv) and Smentioning

confidence: 99%

Effect of hemodialysis on blood volume distribution and cardiac output.

Chaignon¹,

Chen²,

Tarazi³

et al. 1981

Hypertension

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SUMMARY Effects of hemodialysis on extracellular fluid volume distribution, left ventricular volumes, and cardiac output were determined In patients with end-stage renal disease (n = 19). Distribution of extracellular fluid loss from hemodialysis differed widely among patients, so that weight change correlated weakly with contraction of total blood volume (index of determination 29%, p < 0.05). End-diastolic volume (EDV) decreased from 150 ± 49 ml (mean ± SD) to 118 ± 42 ml, p < 0.001; stroke volume (SV) decreased from 108 ± 36 to 86 ± 33 ml (p < 0.001) without change in ejection fraction (from 0.73 ± 0.09 to 0.74 ± 0.11).A significant correlation was found between total blood volume (TBV) and EDV before (r = 0.66, p < 0.005) and after dialysis (r = 0.61, p < 0.01). The correlation between TBV and SV was highly significant before (r = 0.78, p < 0.001) and after dialysis (r = 0.66, p < 0.005), but there was no correlation between change in TBV and change in EDV or in SV. The ratio of EDV to TBV (EDV/TBV X 100) was reduced significantly from 3.49 ± 0.92 to 3.06 ± 0.97, p < 0.001). There results suggest that, although intravascular volume was the major determinant of cardiac output in dialyzed patients, the postdialysis reduction in cardiac output might be related more to the relocation of blood volume than to the absolute degree of blood volume contraction. 8 These include determination of the relative participation from both intravascular and interstitial compartments to the total ECF loss during hemodialysis as well as the effect of hypovolemia on cardiac filling and possible influence of changed preload on cardiac output.

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“…In the earlier studies it was reported that a significant amount of blood (5-142 ml) was retained in the extracorporeal circuit. This was attributed to the poor dialyzer design and their bioincompatibility, leading to enhanced thrombogenicity of the earlier dialyzers [19,20]. However, there have been no studies to quantitate the amount of blood retained in the current better designed and more biocompatible membranes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Blood Loss with Different High-Flux and High-Efficiency Hemodialysis Membranes

Otti

Khajehdehi²,

Fawzy³

et al. 2001

Am J Nephrol

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Iron deficiency is a common problem in patients on chronic HD. Earlier studies have shown significant blood loss per HD session. To identify whether the new more biocompatible high-flux or high-efficiency membranes are also responsible for significant blood loss during HD, we quantitated the amount of blood loss associated with 4 commonly used membranes (F-50, F-80, CA-210, and CT-190). The residual blood in each compartment of extracorporeal circuit was quantitated after total lysis of the red blood cells (RBC), hemoglobin assay, and calculation of the RBC volume using the patient’s hemoglobin and hematocrit concentrations just prior to the study. The average residual RBC volume in different membranes was 0.2–0.3 ml. The residual RBC volume in the dialysis lines (arterial or venous) was 0.1–0.2 ml and did not correlate with the residual RBC volume in the dialysis membranes. The residual RBC volume in the whole extracorporeal circuit (HD membrane, arterial and venous lines) ranged from 0.5 to 0.6 ml. It was significantly higher with F-50 vs. CA-210. The residual RBC volume in the dialysis membrane was significantly higher in the F-80 vs. CA-210 and CT-190 dialyzers. There was also significant difference in the residual RBC volume in the arterial lines of F-50 vs. CT-190, and F-50 vs. F-80 dialyzers. Conclusion: Our results demonstrate for the first time that the total RBC loss per HD session is minimal in chronic HD patients.

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The Role of the Platelet-Dialysis Membrane Interaction in Thrombus Formation and Blood Loss During Hemodialysis

Cited by 31 publications

References 0 publications

Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia

Use of Electron-Beam Sterilized Hemodialysis Membranes and Risk of Thrombocytopenia

Effect of hemodialysis on blood volume distribution and cardiac output.

Comparison of Blood Loss with Different High-Flux and High-Efficiency Hemodialysis Membranes

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