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Altered lung vascular permeability during intermittent haemodialysis
Summary
Intermittent hemodialysis can cause hypoxia. This study found increased lung vascular permeability during hemodialysis, suggesting it contributes to dialysis-induced hypoxia, possibly due to neutrophil activation.
Area of Science:
- Nephrology
- Pulmonary Medicine
- Critical Care
Background:
- Hypoxia is a known complication of intermittent hemodialysis.
- Pulmonary capillary permeability may play a role in dialysis-induced hypoxia.
Purpose of the Study:
- To investigate if increased pulmonary capillary permeability contributes to hypoxia during intermittent hemodialysis.
- To assess lung vascular permeability changes in patients undergoing hemodialysis.
Main Methods:
- A dual-isotope technique using Indium-labelled transferrin and Technetium-labelled red blood cells was employed.
- Lung vascular permeability was measured in eight patients with chronic renal failure before and during hemodialysis.
- A control group of eight individuals was included for comparison.
Main Results:
- A significant increase in lung vascular permeability was observed during hemodialysis compared to predialysis values (P < 0.05).
- This increase in permeability coincided with periods of leucopenia and maximal hypoxia.
- The permeability index was significantly higher during hemodialysis than in controls (P < 0.05).
Conclusions:
- Increased pulmonary vascular permeability may contribute to hypoxia experienced during hemodialysis.
- Neutrophil activation within the pulmonary vasculature might be implicated in this phenomenon.