Hemodialysis Hypoxemia: Evaluation of Mechanisms Utilizing Sequential Ultrafiltration-Dialysis

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Abstract
The role of blood-dialyzer-membrane interactions in hemodialysis-induced hypoxemia was studied by measuring PaO2 [O2 partial pressure] and white blood cell counts during isolated ultrafiltration (UF). These values were compared to those obtained from the same patients during subsequent hemodialysis (HD; utilizing the same dialyzer and membrane). Patients in the UF period displayed no hypoxemia, rather a slight increase in PaO2 (from 82.5 .+-. 3.0 to 88.5 .+-. 2.0 mm Hg, mean .+-. SE, P > 0.05). In contrast, these patients displayed significant hypoxemia when HD was imposed (88.5 .+-. 2.0-78.0 .+-. 1.5 mm Hg, mean .+-. SE, P < 0.02). Apparently the hypoxemia characteristic of HD initiation is not solely dependent on blood-dialyzer-membrane interactions but also requires blood-dialysate interactions.

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