Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study
Patients on haemodialysis (HD) suffer a high mortality rate linked to developing subclinical hypoxic parenchymal stress during HD sessions. The oxygen extraction ratio (OER), an estimate of the oxygen claimed by peripheral tissues, might represent a new prognostic factor in HD patients. This study e...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/138 |
| _version_ | 1797625508771397632 |
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| author | Silverio Rotondi Lida Tartaglione Maria Luisa Muci Marzia Pasquali Nicola Panocchia Filippo Aucella Antonio Gesuete Teresa Papalia Luigi Solmi Alessio Farcomeni Sandro Mazzaferro |
| author_facet | Silverio Rotondi Lida Tartaglione Maria Luisa Muci Marzia Pasquali Nicola Panocchia Filippo Aucella Antonio Gesuete Teresa Papalia Luigi Solmi Alessio Farcomeni Sandro Mazzaferro |
| author_sort | Silverio Rotondi |
| collection | DOAJ |
| description | Patients on haemodialysis (HD) suffer a high mortality rate linked to developing subclinical hypoxic parenchymal stress during HD sessions. The oxygen extraction ratio (OER), an estimate of the oxygen claimed by peripheral tissues, might represent a new prognostic factor in HD patients. This study evaluated whether the intradialytic change in OER (ΔOER) identified patients with higher mortality risks. We enrolled chronic HD patients with permanent central venous catheters with available central venous oxygen saturation (ScvO2) measurements; the arterial oxygen saturation was measured with peripheral oximeters (SpO2). We measured OER before and after HD at enrolment; deaths were recorded during two-years of follow-up. In 101 patients (age: 72.9 ± 13.6 years, HD vintage: 9.6 ± 16.6 years), 44 deaths were recorded during 11.6 ± 7.5 months of follow-up. Patients were divided into two groups according to a 40% ΔOER threshold (ΔOER < 40%, n = 56; ΔOER ≥ 40%, n = 45). The ΔOER ≥ 40% group showed a higher incidence of death (60% vs. 30%; <i>p</i> = 0.005). The survival curve (log-rank-test: <i>p</i> = 0.0001) and multivariate analysis (<i>p</i> = 0.0002) confirmed a ΔOER ≥ 40% as a mortality risk factor. This study showed the intradialytic ΔOER ≥ 40% was a mortality risk factor able to highlight critical hypoxic damage. Using a ΔOER ≥ 40% could be clinically applicable to characterise the most fragile patients. |
| first_indexed | 2024-03-11T09:57:26Z |
| format | Article |
| id | doaj.art-eb1a38fd45ad4241bdbbd8f3d38baf59 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:57:26Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-eb1a38fd45ad4241bdbbd8f3d38baf592023-11-16T15:41:57ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112113810.3390/jcm12010138Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre StudySilverio Rotondi0Lida Tartaglione1Maria Luisa Muci2Marzia Pasquali3Nicola Panocchia4Filippo Aucella5Antonio Gesuete6Teresa Papalia7Luigi Solmi8Alessio Farcomeni9Sandro Mazzaferro10Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, 00185 Rome, ItalyNephrology and Dialysis Unit, Policlinico Umberto I, 00161 Rome, ItalyNephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, 00185 Rome, ItalyNephrology and Dialysis Unit, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Nephrology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, ItalyNephrology Unit, Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, ItalyNephrology Unit, Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, ItalyNephrology, Dialysis and Transplant Unit, Hospital Annunziata, 87036 Cosenza, ItalyNephrology, Dialysis and Transplant Unit, Hospital Annunziata, 87036 Cosenza, ItalyDepartment of Economics & Finance, University of Rome “Tor Vergata”, 00133 Rome, ItalyDepartment of Translation and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyPatients on haemodialysis (HD) suffer a high mortality rate linked to developing subclinical hypoxic parenchymal stress during HD sessions. The oxygen extraction ratio (OER), an estimate of the oxygen claimed by peripheral tissues, might represent a new prognostic factor in HD patients. This study evaluated whether the intradialytic change in OER (ΔOER) identified patients with higher mortality risks. We enrolled chronic HD patients with permanent central venous catheters with available central venous oxygen saturation (ScvO2) measurements; the arterial oxygen saturation was measured with peripheral oximeters (SpO2). We measured OER before and after HD at enrolment; deaths were recorded during two-years of follow-up. In 101 patients (age: 72.9 ± 13.6 years, HD vintage: 9.6 ± 16.6 years), 44 deaths were recorded during 11.6 ± 7.5 months of follow-up. Patients were divided into two groups according to a 40% ΔOER threshold (ΔOER < 40%, n = 56; ΔOER ≥ 40%, n = 45). The ΔOER ≥ 40% group showed a higher incidence of death (60% vs. 30%; <i>p</i> = 0.005). The survival curve (log-rank-test: <i>p</i> = 0.0001) and multivariate analysis (<i>p</i> = 0.0002) confirmed a ΔOER ≥ 40% as a mortality risk factor. This study showed the intradialytic ΔOER ≥ 40% was a mortality risk factor able to highlight critical hypoxic damage. Using a ΔOER ≥ 40% could be clinically applicable to characterise the most fragile patients.https://www.mdpi.com/2077-0383/12/1/138haemodialysisoxygen extractionend-stage renal diseasesubclinical parenchymal hypoxiacentral venous cathetermortality |
| spellingShingle | Silverio Rotondi Lida Tartaglione Maria Luisa Muci Marzia Pasquali Nicola Panocchia Filippo Aucella Antonio Gesuete Teresa Papalia Luigi Solmi Alessio Farcomeni Sandro Mazzaferro Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study Journal of Clinical Medicine haemodialysis oxygen extraction end-stage renal disease subclinical parenchymal hypoxia central venous catheter mortality |
| title | Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study |
| title_full | Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study |
| title_fullStr | Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study |
| title_full_unstemmed | Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study |
| title_short | Oxygen Extraction and Mortality in Patients Undergoing Chronic Haemodialysis Treatment: A Multicentre Study |
| title_sort | oxygen extraction and mortality in patients undergoing chronic haemodialysis treatment a multicentre study |
| topic | haemodialysis oxygen extraction end-stage renal disease subclinical parenchymal hypoxia central venous catheter mortality |
| url | https://www.mdpi.com/2077-0383/12/1/138 |
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