Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Low blood pressure during dialysis increases risk of clots

29.07.2011
A sudden drop in blood pressure while undergoing dialysis has long vexed many kidney patients.

Side effects associated with this situation over the long term range from stroke to seizure to heart damage to death. Patients also suffer in the short term with gastrointestinal, muscular and neurologic symptoms.

Now one more disturbing side effect can be been added to this list.

A study led by researchers at the Stanford University School of Medicine reports an increased risk of blood clotting at the point where the patient's blood vessels are connected to the dialysis machine known as the point of vascular access. Researchers from the University of Utah also contributed to the study, which is to be published online July 29 in the Journal of the American Society of Nephrology.

"Our analysis shows another adverse consequence associated with a fall in blood pressure during dialysis for patients," said Tara Chang, MD, a Stanford nephrologist and lead author of the study. "Vascular access is their lifeline. It's required for dialysis and without dialysis, they'll die."

Dialysis is a life-extending procedure that, for most patients with kidney failure, involves sitting in a chair three or more times a week connected to an artificial kidney machine. Blood is cleansed by exchanging fluid and electrolytes across a membrane during each three- to four-hour session. Patients are attached to the dialysis machine through several means.

This point of vascular access is known as the "Achilles' heel" of patients on dialysis.

One of the most common forms of vascular access is a fistula, which is created surgically from the patient's own blood vessels. The tubes used to take blood to and from the body to the dialysis machine are connected to the body at this access point.

Clotting is one of the primary complications of an access point and can lead to its closure.

"These access points don't last forever," said Chang, a postdoctoral scholar. "Many patients go through multiple access points moving from the right to left arm, or into the legs if necessary after repeated failures in the arms. When a patient runs out of access points, it becomes an emergency situation. Anything you can do to extend the life of the access point is important."

The study was based on results from the Hemodialysis study, known as HEMO — a National Institutes of Health-sponsored randomized clinical trial that collected data from 1,846 patients on hemodialysis from 1995 to 2000. (After exclusions, the data set for this new study included 1,426 patients.)

The researchers found that patients who had the most frequent episodes of low blood pressure during dialysis were two times more likely to have a clotted fistula than patients with the fewest episodes.

About $2 billion a year is spent on vascular access in dialysis patients in the United States. Low blood pressure during dialysis occurs in about 25 percent of dialysis sessions.

"Physicians already try to avoid low blood pressure during dialysis through various means," Chang said. "This is just one more good reason to continue these efforts.

"There is so much we don't know about blood pressure in people on dialysis," she added. "We need future blood pressure management studies to look at not only mortality and hospitalization, but also consider vascular access survival as another important endpoint to study."

Other Stanford contributors include senior author Glenn Chertow, MD, chief of the nephrology division; Jane Paik, PhD, clinical instructor of general internal medicine; Manisha Desai, PhD, clinical associate professor of general internal medicine and of biostatistics; and Fritz Bech, MD, assistant professor of vascular surgery at Stanford and the Palo Alto Veterans Affairs Health Care System.

Chang's research is supported by a grant from the American Heart Association. Chertow's and Desai's work is supported by a grant from the NIH.

Additional information about the Division of Nephrology in Stanford's Department of Medicine, which also supported the research, is available at http://med.stanford.edu/nephrology.

The Stanford University School of Medicine consistently ranks among the nation's top medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For information about all three, please visit http://stanfordmedicine.org/about/news.html.

Michelle Brandt | EurekAlert!
Further information:
http://www.stanford.edu

More articles from Health and Medicine:

nachricht 'Exciting' discovery on path to develop new type of vaccine to treat global viruses
18.09.2017 | University of Southampton

nachricht A new approach to high insulin levels
18.09.2017 | Schweizerischer Nationalfonds SNF

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

Im Focus: Fast, convenient & standardized: New lab innovation for automated tissue engineering & drug

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...

Im Focus: Silencing bacteria

HZI researchers pave the way for new agents that render hospital pathogens mute

Pathogenic bacteria are becoming resistant to common antibiotics to an ever increasing degree. One of the most difficult germs is Pseudomonas aeruginosa, a...

Im Focus: Artificial Enzymes for Hydrogen Conversion

Scientists from the MPI for Chemical Energy Conversion report in the first issue of the new journal JOULE.

Cell Press has just released the first issue of Joule, a new journal dedicated to sustainable energy research. In this issue James Birrell, Olaf Rüdiger,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

New quantum phenomena in graphene superlattices

19.09.2017 | Physics and Astronomy

A simple additive to improve film quality

19.09.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>