Kidney Week

Abstract: SA-PO344

Association Between Intradialytic Central Venous Oxygen Saturation and Relative Blood Volume in Chronic Hemodialysis Patients

Session Information

• Hemodialysis and Frequent Dialysis: Potpourri
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Zhang, Hanjie, Renal Research Institute, New York, New York, United States

Hanjie Zhang,

• Preciado, Priscila, Travere Therapeutics Inc, San Diego, California, United States

Priscila Preciado,

• Rosales, Laura, Renal Research Institute, New York, New York, United States

Laura Rosales,

• Kooman, Jeroen, Maastricht University Medical Center, Maastricht, Netherlands

Jeroen Kooman,

• van der Sande, Frank, Maastricht University Medical Center, Maastricht, Netherlands

Frank van der Sande,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

Background

Central venous oxygen saturation (ScvO₂) is correlated with upper body blood flow and usually declines during hemodialysis (HD). While relative blood volume (RBV) monitoring is widely used to guide ultrafiltration, little is known about the relationship between intradialytic changes of ScvO₂ and RBV.

Methods

We conducted a retrospective study in maintenance HD patients with central venous catheter as vascular access. Crit-Line (Fresenius Medical Care, Waltham, MA) was used to measure intradialytic ScvO₂ and hematocrit (hct). RBV was calculated from hct changes. We applied linear mixed effects models to assess the association between intradialytic changes of ScvO₂ and RBV at the end of dialysis.

Results

We studied 5,231 dialysis sessions in 216 patients (age 62.2±15.7 years; 47% males, UFR 7.1±2.7 mL/kg/h). We observed a significant, direct relationship between intradialytic changes of ScvO₂ and RBV with slope of 0.8 (Fig. 1). Results were materially identical in sessions with an UFR >13 or ≤13 mL/kg/h, respectively.

Conclusion

Our study shows that ScvO2 declines in parallel with RBV in most patients. We posit that this relationship is driven by a decrease in cardiac preload due to intradialytic blood volume decline. The decrease in cardiac preload would then result in a lower cardiac output, hemodynamic stress, and decreased tissue perfusion. Further studies should evaluate the instantaneous, contemporaneous changes of ScvO₂ and RBV during HD.

Funding

• Commercial Support – Renal Research Institute