Optimal hematocrit for the maximum oxygen delivery to the brain with recombinant human erythropoietin in hemodialysis patients

H. Hirakata, H. Kanai, K. Fukuda, K. Tsuruya, I. Ishida, M. Kubo, T. Hirano, E. Hirakata, Y. Kuwabara, M. Fujishima

研究成果: Article

15 引用 (Scopus)

抜粋

Aim: Although hematocrit (Ht) around 33 to 36% has been recommended, Ht of 30% is usually achieved as a target level during recombinant human erythropoletin (rHuEPO) therapy in the majority of hemodialysis (HD) patients. The present study aimed at estimating an optimal hematocrit (Ht) for the maximum oxygen delivery to the brain with rHuEPO. Patients and methods: Oxygen delivery was defined as a product of cerebral blood flow and arterial oxygen content (CaO2). The regional cerebral blood flow (rCBF) in each region of interest was measured by positron emission tomography and CaO2 was calculated from hemoglobin concentration, arterial oxygen saturation, and arterial oxygen tension before and after rHuEPO therapy (1500 units, 3 times a week) in 5 HD patients (the mean age of 52 ± 2 (SEM) years old and the mean HD duration of 98 ± 21 months). Results: Ht rose significantly from 21 ± 1 to 31 ± 1% (p < 0.001) after the 3-month rHuEPO treatment in association with a significant increase in CaO2 from 7.7 ± 0.4 to 11.6 ± 0.3 ml O2/100 ml (p < 0.01). Hemispheric rCBF decreased significantly from 40 ± 3 to 32 ± 1 ml/100 g/min (p < 0.02). In all data both before and after rHuEPO treatment, Ht inversely correlated with the hemispheric rCBF (y = 55.7 - 0.76 x, where y is rCBF and x is Ht, r = -0.80, p < 0.01), and positively with CaO2 (y = 0.85 + 0.34 x, where y is CaO2 and x is Ht, r = 0.95, p < 0.01). By using these correlations, the hemispheric oxygen delivery was expressed as a function of Ht, being y = 47.3 + 18.3 x - 0.3 x2, where y is cerebral oxygen delivery and x is Ht. From this curve, Ht at the highest cerebral oxygen delivery in the hemisphere, i.e. an optimal Ht was found to be 35.2%. Above this level of Ht, the hemispheric cerebral oxygen delivery would rather decline. Conclusion: The present study indicated that Ht of about 35% is required for a better oxygen delivery to the brain metabolism during anemia correction with rHuEPO.

元の言語English
ページ(範囲)354-361
ページ数8
ジャーナルClinical nephrology
53
発行部数5
出版物ステータスPublished - 30-05-2000

All Science Journal Classification (ASJC) codes

  • Nephrology

フィンガープリント Optimal hematocrit for the maximum oxygen delivery to the brain with recombinant human erythropoietin in hemodialysis patients' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用

    Hirakata, H., Kanai, H., Fukuda, K., Tsuruya, K., Ishida, I., Kubo, M., Hirano, T., Hirakata, E., Kuwabara, Y., & Fujishima, M. (2000). Optimal hematocrit for the maximum oxygen delivery to the brain with recombinant human erythropoietin in hemodialysis patients. Clinical nephrology, 53(5), 354-361.