Abstract
The present investigation has been undertaken to elucidate the effects of hemodialysis on the mean volume of regional cerebral blood flow (m.r.CBF) in patients suffering from chronic renal failure.
Eighteen patients who had undergone hemodialysis were studied. Ten patients had chronic glomer. ulonephritis (CGN group) and 8 patients had diabetic nephropathy (DM group). Hemodialysis was performed in the form of acetate dialysis, using a Hollow-fiber type for 4 hours. An infusion of 133Xe was made into the internal carotid artery and the m.r.CBF was measured. Measurement were made 4 times, prior to dialysis, 1 hour and 3 hours after the initiation of dialysis and at the termination of dialysis. At the same time, the arterial blood pressure, cardiac output and blood gas analysis were measured as well.
A comparative study of m.r.CBF in the CGN and DM groups prior to hemodialysis disclosed a higher value in the CGN group, which showed a diclining trend significant after 3 hours. An identical trend was also comfirmed at the termination of hemodialysis. In both groups the value of arterial pH was normalized. However, the blood pressure and cardiac output remained unchanged.
The improvement of acidosis contracted the arterial wall. The improvement of arterial pH was significantly correlated with the decrease of m.r.CBF among patients with CGN. However, in the DM groups, the m.r.CBF was unchanged in spite of the improvement of the acidosis. This could well be explained on the assumption that the persisting arterioscrelosis in this group may exist as one of the resistant factors of the m.r.CBF improvement, while the arterial pH improved markedly. Although a number of previous researchers have observed the effect of hemodialysis on CBF among various groups of patients, the results have sometimes diverged. The reason could be that arterioscrelosis is one of the cardinal influential factors on the m.r.CBF and this fact may lead to various conclusion concerning the functional correlation of m.r.CBF in the CGN and DM groups. This requires further investigative clarification or elcidation in the future.
