Kidney Week

Abstract: FR-PO891

Effects of Hemodialysis, Isolated Ultrafiltration, and Isolated Diffusion on Oxygen Extraction Ratio (OER)

Session Information

• Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

• Rotondi, Silverio, Sapienza University of Rome, Latina, Italy

Silverio Rotondi,

• Tartaglione, Lida, sapienza university of rome, Rome, Italy

Lida Tartaglione,

• Carbone, Luciano, ICOT, Latina, Italy

Luciano Carbone,

• Muci, Maria luisa, Policlinico Umberto I Roma, Roma, Italy

Maria luisa Muci,

• Pasquali, Marzia, Policlinico Umberto I, Rome, Rome, Italy

Marzia Pasquali,

• Mazzaferro, Sandro, Sapienza University of Rome, Rome, Italy

Sandro Mazzaferro,

Background

Hemodialysis sessions cause tissue hypoxia whis is not routinely measured.
OER (n.v. 25-30%), obtained as the ratio between SaO₂ and Central Venous Oxygen Saturation (SvcO₂), is employed in ICU to quantify tissue hypoxic stress.
We aimed to evaluate if the OER : a. Increases during dialysis session; b. is different after long (HD_long) or short (HD_short) dialysis intervals ; c. is differently affected by isolated ultrafiltration (iUf) or isolated diffusion (iD).

Methods

We enrolled 20 clinically stable patients on HD since >6 months, with Central Venous Catheter.
We measured SaO₂ (by capillary oxymeter) and ScvO₂ (by blood gas analysis) to calculate the OER basally, 15’, 30’, 60’, 120’ and end of HD_Long. In 10 of them, OER was re-measured in the following two HD_Short sessions. Further in all patients, OER was re-measured during the first hour of the first and second HD_Short performed by applying, alternatively, iUF or iD.
During each HD, UF rate was kept at<10 ml/kg/h and symptoms were recorded.

Results

In the HD_Long session, OER increased within 30’ (post hoc test p<.05) and then progressively up to the end of HD, by 38%. Mean basal OER of HD_Long (34,4±7), HD_Short1 (33,8±7) and HD_Short2 (36,2±6) were not different (Tab.1). In the two HD_Short sessions, OER changes overlapped with those in HD_Long. During the first hour of the HD_Short session with iUF, the increment of OER was not significant, at variance with the significant increase recorded during the HD_Short with iD (Tab. 1). All HD sessions were asymptomatic with no change in blood pressure (systolic or diastolic) or heart rate. During sessions, no significant change was evident for capillary SaO₂ (98±1 %), while ScvO₂ progressively decreased.

Conclusion

a. OER increases significantly during HD sessions; b. HD intervals do not modify the adaptive process to hypoxia; c. iD affects this adaptive response possibly more than iUF. OER might be a marker of HD stress, potentially useful in fragile patients.

Tab. 1

Funding

• Clinical Revenue Support