Renal Hemodynamic Response to the Creation of Vascular Access in Patients with End-Stage Renal Disease
作者:
CrowleySusan T.,
MorrisseyRichard L.,
SilvermanEugene D.,
YudtWilliam M.,
HirszelPrzemyslaw,
期刊:
Renal Failure
(Taylor Available online 1995)
卷期:
Volume 17,
issue 5
页码: 589-593
ISSN:0886-022X
年代: 1995
DOI:10.1080/0886022X.1995.12098270
出版商: Taylor&Francis
数据来源: Taylor
摘要:
ABSTRACTTo evaluate the possibility that the placement of arteriovenous anastomosis (a/v a) may lead to the attenuation of glomerular hyperfiltration, we studied 5 nondiabetic patients before and after creation of vascular access for hemodialysis. Patients received no EPO and antihypertensive therapy was discontinued 24 h before each study. Cardiac output (CO) and a/v a flow rates were measured by Doppler echo, and GFR and ERPF by plasma decay curves of TC99m DTPA and131l-hippuran, respectively. Other parameters were calculated by standard formulas. Augmentation of CO and decrease in systemic vascular resistance occurred in all patients (p = 0.05), yet renal findings were less predictable since only three patients showed a decrease in renal vascular resistance and filtration fraction post a/v a. Thus, there is a discordant pattern of renal hemodynamic response to the creation of a/v a in end-stage renal disease and further studies are needed to better define the subset of patients who are prone to renal vasodilation after the placement of a/v a.
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