Leukopenia and hypoxemia. Unrelated effects of hemodialysis

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Abstract
Hemodialysis-induced hypoxemia was attributed to membrane-related complement activation leading to pulmonary leukostasis and to hypoventilation secondary to CO2 losses via the dialyzer. The role of membrane-and dialysis-related factors was separately assessed by using different dialyzers and sequential ultrafiltration and hemodialysis. Hemodialysis with first-use cellulose dialyzers produced leukopenia and hypoxemia. With reused cellulose and polyacrylonitrile dialyzers, hypoxemia still occurred, but without leukopenia. Ultrafiltration produced leukopenia and no changes in Pao2 [partial pressure of aortic O2]. During the subsequent hemodialysis, hypoxemia developed as the leukocyte count increased by 50%. Leukopenia and hypoxemia are apparently unrelated effects of hemodialysis, and favor hypoventilation as the major determinant of hypoxemia during hemodialysis.

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