Authors

Citation

S. Ookawara et al., Effect of postural change on blood volume in long-term hemodialysis patients, NEPHRON, 87(1), 2001, pp. 27-34

Citations number

12

Language

INGLESE

art.tipo

Article

Categorie Soggetti

Urology & Nephrology","da verificare

Journal title

NEPHRON

ISSN journal

0028-2766
→ ACNP

Volume

87

Issue

1

Year of publication

2001

Pages

27 - 34

Database

ISI

SICI code

0028-2766(200101)87:1<27:EOPCOB>2.0.ZU;2-4

Abstract

In healthy subjects, the blood volume (BV) increases rapidly after postural
change from standing to the supine position. However, little is known abou
t the effect of postural change on BV in long-term hemodialysis (HD) patien
ts. Therefore, we have examined the BV change caused by adopting the supine
position from standing by continuous hematocrit monitoring, using the CRIT
-LINE instrument, in 8 anuric HD patients. The hematocrit was monitored for
25 min with the patient in the supine position just before HD. The percent
age change in the BV (% Delta BV) was calculated from the hematocrit and ap
proximated using the equation: % Delta BV = b - [1 - exp(-c x time (min)] -
a x time (min). Coefficient a was the slope of the linear part in the % Del
ta BV, b was the magnitude of BV increase and c was the rate of BV increase
. Then we examined the relationship between the coefficients (a, b and c) a
nd clinical parameters. In all patients, % Delta BV increased quickly after
adopting the supine position. The mean increases were 2.8 +/- 0.6% after 5
min and 4.8 +/- 0.5% after 25 min. There was a significant correlation bet
ween the value of % Delta BV calculated from the hematocrit and the value c
alculated using above equation (0.92 < r < 0.99, p < 0.001). Although coeff
icient a did not correlate with a clinical parameter, coefficient b showed
a significant positive linear correlation with the serum albumin level (r =
0.816, p < 0.05) and coefficient c showed a significant positive linear co
rrelation with the percentage change in interdialytic weight gain (r = 0.73
6, p < 0.05). Furthermore, based on the % <Delta> BV, we calculated the cha
nge in total BV, which had increased by 181.5 +/- 21.9 ml after 25 min in t
he supine position. In conclusion, the change in the BV with time by contin
uous hematocrit monitoring using the CRIT-LINE instrument can be approximat
ed by a modified monoexponential equation. BV increased quickly in HD patie
nts after postural change from standing to the supine position. Copyright (
C) 2001 S. Karger AG, Basel.