Department of Life and Environmental Sciences, Teikyo University of Science, 2-2-1 Senjyusakuragi, Adachiku, Tokyo, 120-0045, Japan.
Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato Sagamihara Minamiku, Kanagawa, 252-0373, Japan.
J Artif Organs. 2023 Sep;26(3):212-219. doi: 10.1007/s10047-022-01355-y. Epub 2022 Aug 8.
Factors associated with chronic elevation of the blood lactate levels in patients undergoing chronic maintenance hemodialysis (hereinafter, hemodialysis patients) have not yet been thoroughly investigated. The purpose of the present study was to clarify factors associated with elevated blood lactate levels in hemodialysis patients. We divided the hemodialysis patients into two groups according the blood lactate levels (the high blood lactate group [> 2 mmol/L] and normal blood lactate group), and conducted a retrospective comparison of the following items between the two groups: (1) the creatinine generation rate (%CGR) and the geriatric nutrition risk index (GNRI) as indices of the nutritional status; (2) the left ventricular ejection fraction (LVEF) and E/A, an indicator of diastolic function; (3) the ankle-brachial index (ABI) and transcutaneous partial pressure of oxygen as indices of the adequacy of circulation in the peripheral blood vessels of the lower extremities; (4) the white blood cell count and serum level of C-reactive protein (CRP) before dialysis as markers of an inflammatory state. The mean age and serum CRP level were significantly higher in the high blood lactate group than in the normal blood lactate group. There were no significant differences in the markers of the nutritional status, cardiac function, or adequacy of circulation in the peripheral blood vessels of the lower extremities between the two groups. Advanced age and a state of chronic inflammation appear to be associated with elevated blood lactate levels in patients undergoing chronic maintenance hemodialysis.
尚未深入研究与接受慢性维持性血液透析（以下简称血液透析患者）的患者血液中乳酸水平持续升高相关的因素。本研究旨在阐明与血液透析患者血液中乳酸水平升高相关的因素。我们根据血液乳酸水平将血液透析患者分为两组（高乳酸血症组[>2mmol/L]和正常乳酸血症组），并对两组之间以下项目进行回顾性比较：（1）肌酐生成率（%CGR）和老年营养风险指数（GNRI）作为营养状况的指标；（2）左心室射血分数（LVEF）和 E/A，舒张功能的指标；（3）踝肱指数（ABI）和经皮氧分压作为下肢外周血管循环充足性的指标；（4）透析前白细胞计数和血清 C 反应蛋白（CRP）水平作为炎症状态的标志物。高乳酸血症组的平均年龄和血清 CRP 水平明显高于正常乳酸血症组。两组之间的营养状况、心脏功能或下肢外周血管循环充足性的标志物无明显差异。高龄和慢性炎症状态似乎与慢性维持性血液透析患者血液中乳酸水平升高有关。
