Cellular hypoxia during hemodialysis. Demonstration of intradialytic release of purine and pyrimidine metabolites.

Measurement of hypoxanthine/xanthine has been suggested to be a useful indicator of cellular hypoxia. In humans it has been applied for quantitation of asphyxia in the newborn and hypoxic brain damage after cardiac arrest. To investigate if cellular hypoxia occurs during routine hemodialysis we followed leukocyte count, arterial oxygen tension and plasma hypoxanthine/xanthine in 10 stable dialysis patients. Hemodialysis was associated with transitory leukopenia and decrease in oxygen tension. Plasma hypoxanthine/xanthine increased simultaneously with the decrease in leukocyte count and arterial oxygen tension but returned to normal values at the end of treatment. The study demonstrates that routine hemodialysis, even in stable patients, is associated with cellular hypoxia.