Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension.

BACKGROUND

Intradialytic hypotension (IDH) is a critical pathological condition associated with all-cause mortality in patients undergoing hemodialysis (HD). However, few studies have investigated IDH-related changes in hepatic and cerebral regional tissue oxygen saturation (rSO). This study investigated IDH-induced changes in hepatic and cerebral rSO.

METHODS

Hepatic and cerebral rSO during HD were measured using an INVOS 5100C oxygen saturation monitor, and their percentage (%) changes during the development of IDH were analyzed. Ninety-one patients undergoing HD were investigated, including twenty with IDH.

RESULTS

In patients with IDH, % changes in hepatic and cerebral rSO decreased at the onset of IDH. Additionally, the % change in hepatic rSO was significantly larger than that in cerebral rSO ( < 0.001). In patients without IDH, no significant differences were found between the % changes in hepatic and cerebral rSO at the time of the lowest systolic blood pressure during HD. Multivariable linear regression analysis showed that the difference between the % changes in cerebral and hepatic rSO was significantly associated with the development of IDH ( < 0.001) and the ultrafiltration rate ( = 0.010).

CONCLUSIONS

Hepatic and cerebral rSO significantly decreased during the development of IDH, and hepatic rSO was more significantly decreased than cerebral rSO at the onset of IDH.