Leukopenia and Hypoxemia during Hemodialysis in Chronic Renal Failure

Yeum, Chung Ho; Lee, Je Jung; Chung, You Jeong; Ha, Jeong Hun; Kim, Ki Young; Lee, Seung Cheol; Kim, Soo Wan; Kim, Nam Ho; Choi, Ki Chul; Kang, Young Joon

Abstract

It is well known that patients with chronic renal failure have been treated by hemodialysis to recover their renal function. However, serveral side effects are caused in the clinical treatment with hemodialysis. Especially, leukopenia and hypoxemia are well known as the complications that induced by hemodialysis, when using the cellulose membrane. Although new membranes are developed continually in order to reduce the side effect, the cellulose membrane is still used widely in the treatment with hemodialysis. This Study was undertaken to examine the availability of cellulose membrane with bicarbonate buffer solution in hemodialysis. Complete blood cell count and arterial blood gas analysis were performed during the hemodialysis in 30 patients, who are treated in Artificial Kidney Unit of Chonnam National University Hospital. The results obtained are as follows: 1) Leukopenia was noted at 15 minutes after hemodialysis and was recovered to the basal value in 60 minutes, followed by an increase by 80 minutes. 2) Neutropenia was noted at 15 minutes after hemodialysis and was recovered to the basal value in 60 minutes, followed by an increase to 134.7 % by 180 minutes. 3) Lymphopenia was noted at 15 minutes after hemodialysis and was recovered to the basal value in 60 minutes. 4) Moncytopenia was noted at 15 minutes after hemodialysis and was recovered to the basal value in 120 minutes, followed by an increase to 113.4 % by 180 minutes. 5) Changes in differential counts of WBC were noted at 15 minutes after hemodialysis, but were stabilized in 60 minutes. 6) pH of the arterial blood was increased (from 7.32+/-0.05 to 7.42+/-0.05) at 180 minutes after hemodialysis. 7) PaO2 of the blood was diminished (from 100.9+/-26.3 mmHg to 86.2+/-18.7 mmHg) at 180 minutes after hemodialysis. 8) PaCO2 of the blood showed no significant change (from 38.2+/-3.2 mmHg to 37.7+/-3.4 mmHg) during the hemodialysis. 9) HCO3 of the arterial blood was increased (from 22.4+/-4.6mEq/L to 27.4+/-4.1mEq/L) at 180 minutes after hemodialysis. 10) Base excess of the arterial blood was increased (from -2.5+/-4.7 to 2.9+/-4.5) at 180 minutes after hemodialysis. These observations imply that leukopenia and hypoxemia are still caused during the hemodialysis by using the cellulose membrane, although it is recovered partly. Therefore, new synthetic membrane, which is more biocompatible, should be developed in order to prevent the side effect in hemodialysis.