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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
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Immediate effects of hemodialysis on upper extremity and cognitive function
David Warner1, David Louie1, John Campiche1
1Division of Vascular Surgery, Oregon Health & Science University, United States.
American Journal of Surgery
|March 9, 2021
Summary
Hemodialysis does not cause immediate upper extremity or cognitive impairment in hospitalized patients. Hand dexterity significantly improves the day after dialysis, contrary to common patient perceptions of weakness.
Area of Science:
- Nephrology
- Neurology
- Physical Medicine and Rehabilitation
Background:
- Patients undergoing hemodialysis frequently report post-dialysis weakness and fatigue.
- These subjective experiences have not been objectively quantified.
- This study aimed to objectively assess functional changes after hemodialysis.
Purpose of the Study:
- To evaluate objective changes in upper extremity and cognitive function immediately after hemodialysis.
- To determine the duration of any functional deficits or recovery.
- To compare functional outcomes based on vascular access type (fistula vs. central venous catheter).
Main Methods:
- Inpatient hemodialysis subjects underwent assessments of grip strength, pinch strength, dexterity, and cognitive function.
- Evaluations were performed immediately pre-dialysis, immediately post-dialysis, 3 hours post-dialysis, and the following morning.
- Both dialysis and non-dialysis extremities were assessed, with results stratified by access type.
Main Results:
- No significant changes in grip strength, pinch strength, or dexterity were observed immediately or 3 hours post-dialysis.
- Mini-mental status exam scores showed a non-significant trend towards reduction 3 hours post-dialysis.
- Hand dexterity significantly improved the morning after dialysis (p=0.049).
- Patients with central venous catheters experienced reduced grip strength 3 hours post-dialysis compared to those with fistulas (p=0.018), which resolved by the next day.
Conclusions:
- Hospitalized patients undergoing hemodialysis do not exhibit acute objective deficits in upper extremity or cognitive function.
- Hand dexterity shows significant improvement by the day following hemodialysis.
- Vascular access type may influence short-term grip strength recovery.
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