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Updated: Jun 10, 2026
08:39
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
Impaired peripheral micro- and macrocirculation during hemodialysis in uremic patients
P Santesson1, A Danielsson, I Iseda
1Divisions of Medicine, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. gun.jorneskog@ds.se
Summary
Hemodialysis significantly impairs peripheral circulation in end-stage renal disease (ESRD) patients, affecting both microcirculation and blood pressure. These circulatory effects are consistent across multiple treatments and patient types.
Area of Science:
- Nephrology
- Cardiovascular Physiology
- Vascular Biology
Background:
- Hemodialysis can cause acute hemodynamic shifts.
- Peripheral circulatory compromise is a concern in end-stage renal disease (ESRD) patients.
Purpose of the Study:
- To assess the impact of three consecutive hemodialysis sessions on peripheral microcirculation and macrocirculation in ESRD patients.
- To investigate potential differences between diabetic and non-diabetic ESRD patients.
Main Methods:
- Evaluated 20 ESRD patients (10 diabetic, 10 non-diabetic) over one week.
- Measured skin microcirculation using transcutaneous oxygen tension (tcPO2) and laser Doppler fluxmetry for maximum microvascular hyperemia (MMH).
- Assessed macrocirculation via arm blood pressure (BP) and toe BP.
Main Results:
- Significant reductions observed in MMH, tcPO2 (foot and chest), arm BP, and toe BP during hemodialysis.
- No significant differences noted between hemodialysis days or between diabetic and non-diabetic groups.
- Some patients experienced toe BP and tcPO2 levels indicative of high gangrene risk.
Conclusions:
- Hemodialysis impairs peripheral micro- and macrocirculation in ESRD patients.
- The observed circulatory effects are reproducible and consistent across diabetic and non-diabetic individuals.
- Patients with peripheral arterial occlusive disease may be more vulnerable to blood pressure reduction during hemodialysis.
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