Zusammenfassung
Bei 10 Langzeitdialysepatienten wurden Erythrocyten- und Plasmavolumina vor und nach Dialyse sowie mehrmals in den folgenden 3 Tagen gemessen, um die Veränderungen des intravasculären Volumens während eines Dialysezyklus zu erfassen und um zu beurteilen, ob ein Zusammenhang mit Dialysenebenerscheinungen vorhanden war. Das Plasmavolumen (PV) nahm von 23,7±1,5 vor auf 20,7±1,5 ml/cm Körperlänge ab. Unerwarteterweise war es 16 h später noch etwas tiefer (20,1±1,4 ml/cm), währenddem unerwünschte Dialysesymptome zu diesem Zeitpunkt verschwunden waren. Dies wies darauf hin, daß eine Reduktion des PV nicht die Ursache dieser Symptome war oder daß bei den Patienten eine Adaptation eingetreten war. Veränderungen des PV korrelierten besser mit Veränderungen des Hämatokrit (r=0,89) als mit denjenigen des Körpergewichts (r=0,60). Sorgfältige Hämatokritbestimmungen sind deshalb bei diesen Patienten zur Erfassung von kurzfristigen Blutvolumenschwankungen geeignet.
Summary
In 10 patients on maintenance dialysis red cell and plasma volumes (PV) were measured before and after dialysis and several times during the next 3 days in order to establish the usual pattern of intravascular variation associated with this treatment and to determine whether there was a correlation with dialysis induced untoward effects. PV decreased from 23.7±1.5 before to 20.7±1.5 ml/cm body height immediately after dialysis. Unexpectly it was even slightly lower 16 h later (20.1±1.4 ml/cm). Nevertheless, undesired dialysis symptoms had disappeared by that time indicating that they had not been caused by a reduction in PV or that the patients had adapted to it. Changes in PV correlated better with changes in hematocrit (r=0.89) than with changes in body weight (r=0.60). Therefore careful determination of the large vessel hematocrit offers a reliable estimation of blood volume variations over short periods.
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Supported by Grant No. 27200562, Swiss National Fund for the Advancement of Scientific Research
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Tuckman, J., Blumberg, A. Serial measurements of total blood volume in patients on maintenance hemodialysis. Klin Wochenschr 54, 735–738 (1976). https://doi.org/10.1007/BF01470465
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DOI: https://doi.org/10.1007/BF01470465