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Liver blood flow in chronic hemodialysis patients
M Leblanc1, L F Roy, J P Villeneuve
1André-Viallet Clinical Research Center, Université de Montréal, P.Q., Canada.
Insights
Chronic hemodialysis patients show similar liver blood flow compared to healthy individuals. Cardiac output was higher in hemodialysis patients, but liver blood flow remained unaffected by the dialysis procedure.
Area of Science:
- Nephrology
- Hepatology
- Cardiology
Background:
- Chronic kidney disease patients undergoing hemodialysis often experience altered physiological parameters.
- Understanding liver blood flow and cardiac output is crucial for managing these patients.
Purpose of the Study:
- To assess liver blood flow and cardiac output in chronic hemodialysis patients before and after dialysis.
- To compare these parameters with those of healthy volunteers.
Main Methods:
- Liver blood flow was determined using the hepatic clearance of sorbitol.
- Cardiac output was evaluated using echocardiograms.
- Study included 7 chronic hemodialysis patients and 11 healthy volunteers.
Main Results:
- Cardiac output was higher in hemodialysis patients (predialysis: 4.7 ± 1.8 L/min, postdialysis: 4.5 ± 0.9 L/min) compared to normal subjects (3.8 ± 0.9 L/min).
- Hepatic blood flow, measured by sorbitol clearance, was similar in hemodialysis patients (pre- and post-dialysis: 1,610 ± 266 and 1,541 ± 415 ml/min) and controls (1,565 ± 313 ml/min).
- The hepatic extraction ratio of sorbitol was slightly decreased in hemodialysis patients (0.87 ± 0.03) compared to healthy subjects.
Conclusions:
- Liver blood flow is not significantly altered in patients undergoing chronic hemodialysis.
- While cardiac output is elevated in hemodialysis patients, this does not appear to impact hepatic blood flow.
Abstract:
The purpose of this study was to assess liver blood flow and cardiac output in chronic hemodialysis patients (n = 7) before and after a hemodialysis session, and to compare it to normal volunteers (n = 11). We used the hepatic clearance of sorbitol to calculate liver blood flow and echocardiograms to evaluate cardiac output. The latter was higher in hemodialysis patients (predialysis 4.7 +/- 1.8 liters/min, postdialysis 4.5 +/- 0.9 liters/min) compared to normal subjects (3.8 +/- 0.9 liters/min, p = 0.09 and p = 0.05). Hepatic blood clearance of sorbitol was similar in hemodialysis patients before and after dialysis (1,610 +/- 266 and 1,541 +/- 415 ml/min) as well as in normal volunteers (1,565 +/- 313 ml/min). The hepatic extraction ratio of sorbitol is slightly decreased in hemodialysis patients (n = 3) (0.87 +/- 0.03) compared to values reported in the literature for healthy subjects. We conclude that liver blood flow is not significantly altered in hemodialysis patients.