Haemodialysis decreases finger pressures independent of artificial kidney blood flow

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 questi...

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Published in:Nephrology (Carlton, Vic.) Vic.), 2010-08, Vol.15 (5), p.555-559
Main Authors: VAN HOEK, FRANK, SCHELTINGA, MARC R, HOUTERMAN, SASKIA, BEERENHOUT, CHARLES H
Format: Article
Language:English
Subjects:
Aged
Arteriovenous Shunt, Surgical - adverse effects
Blood Pressure
Body Temperature
Female
Fingers - blood supply
haemodialysis
HAIDI
Heart Rate
Humans
hypotension
Hypotension - blood
Hypotension - etiology
Hypotension - physiopathology
ischaemia
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
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Summary: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 (Pdig), finger temperature (Tdig), oxygen saturation and ischaemic scores were monitored during two different arterial blood flow dialysis sessions. Results:  Before dialysis, Pdig and Tdig of the arteriovenous access hand were significantly lower compared with the other hand. Haemodialysis induced a drop of Pdig in both hands. All changes in Pdig 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. Digital ischaemia associated with fistulae is a common problem – this paper examines local blood flows and the influence of dialysis blood flow rates on this.
ISSN:1320-5358
1440-1797
DOI:10.1111/j.1440-1797.2009.01271.x