Dialysis-Induced Hypoxemia

Nd, Vaziri

doi:10.1177/039139888200500104

Cited by 13 publications

(3 citation statements)

References 21 publications

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“…there are until now no arguments that mixed venous blood composition plays any role in the hypoventilation during hemodialysis. The possibility of a direct effect of acetate on ventilation, as already stressed previously (3)(4)(5) has still to be ques tioned. Other methods, using continuous, highly accu rate, measurements of blood gases are necessary.…”

Section: Discussionmentioning

confidence: 96%

Hypoventilation during Hemodialysis

Lins¹,

Verresen²,

Backer³

et al. 1986

Nephron

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Section: Discussionmentioning

confidence: 96%

Hypoventilation during Hemodialysis

Lins¹,

Verresen²,

Backer³

et al. 1986

Nephron

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“…Numerous pa pers have dealt with this problem since it was first described by Johnson et al [89] in 1971. Several reviews have been published on the subject [90][91][92][93]. When all the information is analyzed with a critical eye, it appears that P a0 2 decreases markedly with acetate, but not with bicarbonate dialysis [94,95].…”

Section: Hypoxemia During Hemodialysis With Acetate and Bicarbonatementioning

confidence: 99%

Acetate Metabolism during Hemodialysis: Metabolic Considerations

et al. 1987

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Acetate is used during regular hemodialysis to replace the bicarbonate lost during dialysis. The temporal changes of plasma bicarbonate and acetate concentrations and the critical role of acetate metabolism for the maintenance of plasma bicarbonate are described. We point out that the maximal rate of acetate oxidation in man is usually reached during dialysis, and we identify physiologic and pathologic factors that may modify this V_max. A syndrome of ‘intolerance to acetate’ has been described. This syndrome is analyzed in the light of the metabolic consequences of a rapid flux of acetate oxidation in liver and muscle cells. More specifically, the effects of rapid acetate metabolism on tissue ATP, CoA, adenosine and other ATP degradation products are presented. The possible impact of dialysis-induced depletion of carnitine on optimal acetate metabolism is discussed. The potential clinical consequences produced by these changes are presented in relation to the symptoms sometimes observed during dialysis against acetate: vasodilation, hypotension and angina pectoris. The hypoxemia induced by acetate is also briefly reviewed. Different directions are proposed for future research.

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“…

The pathogenesis of dialysis-induced hypoxemia is still not fully clarified [1], Several mechanisms have been pro posed, of which however only two deserve special attention. Craddock et al [2] have emphasized the importance of the initial leucocytopenia for the development of the hypoxe mia.

…”

mentioning

confidence: 99%