Wehle B, Asaba H, Castenfors J, Fürst P, Gunnarsson B, Shaldon S, Bergström J
Kidney Int. 1979 Apr;15(4):411-8. doi: 10.1038/ki.1979.53.
Seven patients on regular dialysis were studied to elucidate the hemodynamic changes during ultrafiltration and dialysis, performed sequentially, the period of ultrafiltration (1 hour) either preceding or following dialysis (3 hours). During dialysis ultrafiltration was prevented by applying positive pressure in the dialysate compartment. Cardiac index (dye dilution: indocyanine green), heart rate, stroke volume index, blood pressure, and total peripheral vascular resistance index were measured. During ultrafiltration, cardiac index and stroke volume index decreased, but heart rate was not significantly changed. Total peripheral vascular resistance increased, resulting in unchanged blood pressure. During dialysis, the total peripheral vascular resistance decreased, but cardiac index and heart rate increased. BP decreased when the increase in cardiac index was insufficient to compensate for the decrease in total peripheral vascular resistance. PRA increased during ultrafiltration due to hypovolemia and decreased during dialysis, presumably due to decreased sympathetic activity which may also be a cause of dialysis-induced vasodilation.
对7名接受定期透析的患者进行了研究，以阐明在依次进行超滤和透析过程中的血流动力学变化，超滤期（1小时）在透析期（3小时）之前或之后。在透析期间，通过在透析液腔室施加正压来防止超滤。测量了心脏指数（染料稀释法：吲哚菁绿）、心率、每搏量指数、血压和总外周血管阻力指数。在超滤期间，心脏指数和每搏量指数下降，但心率没有显著变化。总外周血管阻力增加，导致血压不变。在透析期间，总外周血管阻力下降，但心脏指数和心率增加。当心脏指数的增加不足以补偿总外周血管阻力的下降时，血压下降。超滤期间，由于血容量不足，肾素活性增加，透析期间肾素活性下降，可能是由于交感神经活动减少，这也可能是透析诱导血管舒张的原因。
