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Cerebral oxygenation changes in response to post-hemodialysis standing

  • Original Article
  • Artificial Kidney / Dialysis
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Abstract

Few reports have examined the association between changes in cerebral oxygenation and clinical factors, including blood pressure (BP), upon standing after hemodialysis (HD). This study aimed to clarify the factors affecting the changes in cerebral regional oxygen saturation (rSO2) upon standing after HD and monitor the differences in cerebral rSO2 changes that occur upon standing after HD in patients with and without diabetes mellitus (DM). Changes in mean BP and cerebral rSO2 were tracked in 43 HD patients during 120 s of standing after HD using an INVOS 5100c oxygen saturation monitor. The post-HD cerebral rSO2 at rest was 55.8 ± 10.2%, while that at 120 s of standing decreased to 51.9 ± 9.6%; therefore, the percentage change in cerebral rSO2 at 120 s of standing was − 6.8 ± 6.4%, which was significantly lower than before HD (p < 0.001). This change was significantly correlated with the presence of DM, HD duration, mean BP at 120 s of standing, and percentage change in mean BP at 120 s of standing. A multivariable linear regression analysis showed that percentage change in cerebral rSO2 at 120 s of standing was independently associated with the percentage change in mean BP at 120 s of standing (standardized coefficient: 0.432; p = 0.004). Furthermore, there were significant decreases in percentage changes in cerebral rSO2 throughout the standing period in HD patients with versus without DM. Therefore, cerebral oxygenation deterioration upon standing after HD should receive attention, particularly in HD patients with DM.

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Acknowledgements

We thank the study participants and the staff of the hospitals’ clinical dialysis centers. We would like to thank Editage (www.editage.com) for English language editing.

Funding

This work was supported by JSPS KAKENHI (Grant No. JP20K11534) to SO and JSPS KAKENHI (Grant No. 21K16192) to KI. The funder of this study had no role in the study design, data collection, analysis and interpretation, manuscript writing, or decision to submit the manuscript for publication.

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Author notes

  1. Sojiro Imai, Susumu Ookawara and Kiyonori Ito have contributed equally to this work.

Authors and Affiliations

  1. Department of Dialysis, Minami-Uonuma City Hospital, Niigata, Japan

    Sojiro Imai, Takashi Hattori, Mariko Fueki, Miho Iguchi & Satoshi Kiryu

  2. Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan

    Susumu Ookawara, Kiyonori Ito & Yoshiyuki Morishita

  3. Division of Neurology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Hidenori Sanayama

  4. Department of Internal Medicine, Minami-Uonuma City Hospital, Niigata, Japan

    Masafumi Kakei & Kaoru Tabei

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  1. Sojiro Imai
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  2. Susumu Ookawara
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Contributions

Research idea and study design: Susumu Ookawara, Kiyonori Ito; data acquisition: Sojiro Imai, Susumu Ookawara, Kiyonori Ito, Takashi Hattori, Mariko Fueki, Miho Iguchi, Satoshi Kiryu, Hidenori Sanayama; data analysis: Sojiro Imai, Susumu Ookawara, Kiyonori Ito; statistical analysis: Susumu Ookawara, Kiyonori Ito; supervision: Masafumi Kakei, Kaoru Tabei, Yoshiyuki Morishita; and manuscript draft: Sojiro Imai, Susumu Ookawara, Kiyonori Ito. Each author contributed important intellectual content during the manuscript drafting, accepts personal accountability for their own contributions, and agrees to ensure that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

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Correspondence to Susumu Ookawara or Kiyonori Ito.

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Imai, S., Ookawara, S., Ito, K. et al. Cerebral oxygenation changes in response to post-hemodialysis standing. J Artif Organs 26, 127–133 (2023). https://doi.org/10.1007/s10047-022-01343-2

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  • DOI: https://doi.org/10.1007/s10047-022-01343-2

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