부산대학교 도서관

Brain tissue oxygenation (rSO2) measured by near-infraredspectroscopy (NIRS) is lower in hemodialysis patients than in thehealthy population and is associated with cognitive dysfunction.The involved mechanisms are not known. We conducted thisstudy to identify the factors that influence the rSO2 values in endstage renal disease (ESRD) patients and to describe rSO2changes during hemodialysis. We included a cohort of ESRDpatients hemodialyzed in our institution. We recorded rSO2 usingINVOS 5100C oximetry system (Medtronic, Essex, U.K.) andanalyzed changes in basic laboratory values and hemodynamicfluctuations. Baseline rSO2 was lower in patients with heartfailure (45.2±8.3 % vs. 54.1±7.8 %, p=0.006) and wassignificantly linked to higher red cell distribution width (RDW)(r=-0.53, p˂0.001) and higher BNP level (r=-0.45, p=0.01). TherSO2 value decreased in first 15 min of hemodialysis, thisdecrease correlated with drop in white blood count duringthe same period (r=0.43, p=0.02 in 10 min, r=0.43, p=0.02 in20 min). Lower rSO2 values in patients with heart failure andhigher RDW suggest that hemodynamic instability combined withvascular changes probably leads to worse cerebral oxygenation inthese patients. Decrease of rSO2 in 15th minute of hemodialysisaccompanied with a significant drop in leukocyte count could beexplained by complement activation.