Haemodialysis decreases finger pressures independent of artificial kidney blood flow

Nephrology (Carlton). 2010 Aug;15(5):555-9. doi: 10.1111/j.1440-1797.2009.01271.x.

Abstract

Background: During haemodialysis, some patients experience intensification of symptoms of haemodialysis access-induced distal ischaemia. Aim of this study is to compare the effects of two different regimens of arterial blood flow in patients with an arteriovenous access.

Methods: A questionnaire identified 10 patients that subjectively experienced ischaemic symptoms during haemodialysis. Systolic blood pressure, heart rate, finger pressure (P(dig)), finger temperature (T(dig)), oxygen saturation and ischaemic scores were monitored during two different arterial blood flow dialysis sessions.

Results: Before dialysis, P(dig) and T(dig) of the arteriovenous access hand were significantly lower compared with the other hand. Haemodialysis induced a drop of P(dig) in both hands. All changes in P(dig) occurred independent of the artificial kidney's blood flow level.

Conclusion: Systemic hypotension following onset of haemodialysis further intensifies an already diminished hand perfusion. Measures preventing dialytic hypotension will likely attenuate symptoms associated with haemodialysis access-induced distal ischaemia during haemodialysis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Blood Pressure*
  • Body Temperature
  • Female
  • Fingers / blood supply*
  • Heart Rate
  • Humans
  • Hypotension / blood
  • Hypotension / etiology*
  • Hypotension / physiopathology
  • Ischemia / blood
  • Ischemia / etiology*
  • Ischemia / physiopathology
  • Male
  • Middle Aged
  • Netherlands
  • Oxygen / blood
  • Regional Blood Flow
  • Renal Circulation*
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / methods
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Oxygen