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SINGLE-NEEDLE DİYALİZDE HEMOLİZ VE RESİRKÜLASYON

HEMOLYSIS AND RECIRCULATION IN SINGLE NEEDLE DIALYSIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1995

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
We performed standard two-needle dialysis (TND) in 16 patients through double lumen subclavian cat¬heters and single-needle dialysis (SND) in 16 patients through single-lumen catheter, all of whom had end stage renal failure, and compared these two groups with respect to hemolysis and recirculation (R). Blood urea nitrogen (BUN), lactic dehydrogenase (LDH), potassium, hemoglobin (Hb) and plasmafree Hb levels were determined before and after hemodi-alysis (HD). Plasma free Hb levels were measured spectrophotometrically. R % values were calculated from the BUN values in blood samples obtained from peripheral vein, arterial and venous lines simultaneo¬usly in the last five minutes ofHD. There were no differences between the two groups in respect to predialysis plasma free Hb, LDH and po¬tassium values. The percentage of R, post dialysis plasma free Hb, LDH and potassium values in the SND group were significantly higher than those of the TND group; however, the percentage of reduction in BUN was found to be lower in the SND group. A posi¬tive significant correlation was present between mean R % values and post dialysis plasma free Hb levels (r= 00.68, p< 0.0001). We conclude that the high recirculation rates in SND led to intravascular hemolysis as well as decrea¬se in HD efficiency. Hemolysis did not change total Hb level. No significant difference in post dialysis se¬rum potassium level was detected in the SND group because of potassium release resulting from hemolysis and thus SND is not suitable in hyperpotassemic and hypercatabolic patients.
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Abstract (Original Language): 
Son dönem böbrek yetmezliği bulunan 16 hastaya çift lümenli subclavian kalelerle standart two-needle diyaliz (TND), 16 hastaya da tek lümenli kalelerle single-needle diyaliz (SND) uygulanarak resirkülasyon (R) ve hemoliz yönünden bu iki grup karşılaştırıldı. Hastalarda hemodiyaliz (HD) öncesi ve sonrası plazma serbest hemoglobin (Hb) düzeyleri ile hemoli-zin indirekt bulguları olan LDH ve potasyum değerleri tayin edildi. Ayrıca HD'in son 5 dakikasındaperife-rik ven ile arteriyel ve venöz setlerden aynı anda alı¬nan kan örneklerindeki BUN düzeylerinden % R de¬ğerleri hesap edildi. Diyaliz öncesi değerler bakımından iki grup ara¬sında herhangi bir farklılık yoktu. SND uygulanan hastalarda R oranı, diyaliz sonu plazma serbest Hb, LDH ve potasyum değerleri TND uygulanan gruptan önemli derecede daha yüksek, BUNdaki azalma oranı ise daha düşük bulundu. Hastaların % R değerleri ile diyaliz sonu serbest Hb düzeyleri arasında pozitif an¬lamlı bir korelasyon mevcuttu (r= 0.68, p< 0.0001). Sonuç olarak, SNDdeki artmış R'un HD etkinli¬ğinde azalmanın yanısıra, intravasküler hemolize de neden olduğu; hemolizin total Hb seviyesini değiştire¬cek düzeyde olmadığı ancak hemoliz sonucu açığa çı¬kan potasyum nedeniyle bu grupta diyaliz sonu serum potasyum düzeyinde önemli bir değişiklik görülmedi¬ği, bu nedenle hiperpotasemisi olan hiperkatabolik hastalarda SND'in uygun olmayacağı sonucuna varıldı.
FULL TEXT (PDF): 
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  • 3
141-145
  • Turkish

REFERENCES

References: 

1. Perez RJR, Cubille LP, Hidalgo JV. Hemolysis during hemodialysis. Dial Transplant 1986; 15 (6): 334-335.
2. Klingman H, Baumeister U, Davison AM. The consen¬sus conference of biocompability: a contribution to the solution of the biocompability puzzle. Nephrol Dial Transplant 1994; 9 (Suppl 2): 17-25.
3. Keshaviah P. Equipment for hemodialysis and peritoneal dialysis. In: Nissenson AR, Fine RN, Gentile DE (eds). Clinical Dialysis (second ed). Prentice-Hall International Inc 1990; pp. 45-68.
4. Depner TA. Assessing adequacy of hemodialysis: Urea
modeling. Kidney Int 1994; 45: 1522-1535.
5. Fairbanks VF, Klee GG. Biochemical aspects of hema-tology In: Tietz NW (ed). Textbook of clinical Che¬mistry. WB Saunders Company, Philadelphia-USA
1986; pp. 1532-1536.
6. Windus DW, Audrain J, Vanderson R, Jendrisak MD, Picus D, Delrriez JA. Optimization of high-efficiency hemodialysis by detection and correction of fistula
dysfunction. Kidney Int 1990; 38: 337-341.
7. Gassock RJ. Hematuria and pigmenturia (Chapter 32). In: Massry SG, Glassock RJ (eds). Textbook of Nephro-logy (second ed). Williams-Wilkins, Baltimore 1989; pp. 491-500.
8. Nand SN, Bansal VK, Kozeny G, Vertuno L, Remlinger KA, Jordan JV. Red cell fregmentation syndrome with the use of subclavian hemodialysis catheters. Arch In¬tern Med 1985; 145: 1421-1423.
9. Calzavara P, Angeli S, Nieri A, Furlan C, Bolzonella R, Porte A. Alterations in erythrocyte morphology induced
by blood pumps. Int J Artif Organs 1993; 16 (9): 653¬658.
10. Blumental SS, Ortis MA, Kleinman JG, Piering WF. Inf¬low-time and recirculation in single-needle hemodialy-
sis. Am J Kidney Dis 1986; 8 (3): 202-206.
11. Alfred HJ, Warns G, Powell P, Deedy P, Morgenthaler J. Comparison of single and double neetle treatment effi¬ciency with a single pump pressure-pressure controlled
device. Kidney Int 1989; 35 (1): 237.
12. Buoncristiani C, Quintaliani G, Cozzari M, Ragaiolo M, Giombini L. Double lumen single needle: Long term cli¬nical trial with daily dialysis. Abstractb of the XXIInd Congress of the EDTA-ERA, Brussels, Belgium, June
25-29, 1985; p. 102.
13. Sherman RA, Levy SS. Rate-related recirculation: The effect of alteming blood flow on dialyzer recirculation.
Am J Kidney Dis 1991; 17 (2): 170-173.
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