Factors affecting cerebral oxygenation in hemodialysis patients: cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus.

Patients undergoing hemodialysis (HD) often develop cerebral disease complications. Furthermore, cerebral regional saturation of oxygen (rSO2) was previously reported to be significantly lower in HD patients than in healthy subjects. We aimed to identify the factors affecting the cerebral rSO2 in HD patients.Fifty-four HD patients (38 men and 16 women; mean age, 67.7 ± 1.2 years, HD duration, 6.5 ± 1.9 years) were recruited. Cerebral rSO2 was monitored at the forehead before HD using an INVOS 5100C (Covidien Japan, Tokyo, Japan).The rSO2 levels were significantly lower in HD patients compared with healthy controls (49.5 ± 1.7% vs. 68.9 ± 1.6%, p <0.001). Multiple regression analysis showed that cerebral rSO2 independently associated with pH (standardized coefficient: -0.35), HD duration (standardized coefficient: -0.33), and serum albumin concentration (standardized coefficient: 0.28). Furthermore, the rSO2 was significantly lower in HD patients with diabetes mellitus (DM), compared with patients without DM (46.8 ± 1.7% vs. 52.1 ± 1.8%, p <0.05).In HD patients, cerebral rSO2 was affected by multiple factors, including pH, HD duration, and serum albumin concentration. Furthermore, this is the first report describing significantly lower levels of rSO2 in HD patients with DM than in those without DM

A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation

A high cardiothoracic ratio (CTR) is indicative of a cardiac disorder. However, few reports have revealed an association between the CTR and mortality in patients starting hemodialysis (HD). Methods: Patients with HD initiation (n = 387; mean age, 66.7 ± 12.7 years) were divided into the following three groups according to their CTR at HD initiation: CTR Results: Sixty-five patients (17%) died within 2 years after HD initiation. Kaplan-Meier analysis showed that patients with CTR ≥55% had a higher mortality rate than those in the other groups. Cox proportional hazard regression analysis was performed using parameters with p values Conclusion: CTR >55% is one of the most important independent factors to affect 2-year all-cause mortality. Thus, confirming the cardiac condition of patients at HD initiation with a CTR >55% may improve their survival

Different clinical parameters for hemodialysis patients with and without diabetes mellitus.

<p>Different clinical parameters for hemodialysis patients with and without diabetes mellitus.</p

Comparison of cerebral rSO₂ in hemodialysis patients (HD) with and without diabetes mellitus (DM).

<p>* < 0.05 at HD patients with DM vs. those without DM.</p

Correlation between hemodialysis duration and rSO₂.

<p>Correlation between hemodialysis duration and rSO₂.</p

Patients Characteristics and the correlation between cerebral rSO₂ and clinical parameters.

<p>Patients Characteristics and the correlation between cerebral rSO₂ and clinical parameters.</p

Multivariate linear regression analysis: Independent factors of cerebral rSO₂ in hemodialysis patients.

<p>Multivariate linear regression analysis: Independent factors of cerebral rSO₂ in hemodialysis patients.</p