Cargando…

Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring

BACKGROUND: Relative blood volume (RBV) changes during hemodialysis (HD) are typically estimated based on online measurements of hematocrit, hemoglobin or total blood protein. The aim of this study was to assess changes in the above parameters during HD in order to compare the potential differences...

Descripción completa

Detalles Bibliográficos
Autores principales: Pstras, Leszek, Debowska, Malgorzata, Wojcik-Zaluska, Alicja, Zaluska, Wojciech, Waniewski, Jacek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690539/
https://www.ncbi.nlm.nih.gov/pubmed/31404089
http://dx.doi.org/10.1371/journal.pone.0220764
_version_ 1783443203952738304
author Pstras, Leszek
Debowska, Malgorzata
Wojcik-Zaluska, Alicja
Zaluska, Wojciech
Waniewski, Jacek
author_facet Pstras, Leszek
Debowska, Malgorzata
Wojcik-Zaluska, Alicja
Zaluska, Wojciech
Waniewski, Jacek
author_sort Pstras, Leszek
collection PubMed
description BACKGROUND: Relative blood volume (RBV) changes during hemodialysis (HD) are typically estimated based on online measurements of hematocrit, hemoglobin or total blood protein. The aim of this study was to assess changes in the above parameters during HD in order to compare the potential differences in the RBV changes estimated by individual methods. METHODS: 25 anuric maintenance HD patients were monitored during a 1-week conventional HD treatment. Blood samples were collected from the arterial dialysis blood line at the beginning and at the end of each HD session. The analysis of blood samples was performed using the hematology analyzer Advia 2120 and clinical chemistry analyzer Advia 1800 (Siemens Healthcare). RESULTS: During the analyzed 30 HD sessions with ultrafiltration in the range 0.7–4.0 L (2.5 ± 0.8 L) hematocrit (HCT) increased by 9.1 ± 7.0% (mean ± SD), hemoglobin (HGB) increased by 10.6 ± 6.3%, total plasma protein (TPP) increased by 15.6 ± 9.5%, total blood protein (TBP) increased by 10.4 ± 5.8%, red blood cell count (RBC) increased by 10.8 ± 7.1%, while mean corpuscular red cell volume (MCV) decreased by 1.5 ± 1.1% (all changes statistically significant, p < 0.001). HGB increased on average by 1.5% more than HCT (p < 0.001). The difference between HGB and TBP increase was insignificant (p = 0.16). CONCLUSIONS: Tracking HGB or TBP can be treated as equivalent for the purpose of estimating RBV changes during HD. Due to the reduction of MCV, the HCT-based estimate of RBV changes may underestimate the actual blood volume changes.
format Online
Article
Text
id pubmed-6690539
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-66905392019-08-15 Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring Pstras, Leszek Debowska, Malgorzata Wojcik-Zaluska, Alicja Zaluska, Wojciech Waniewski, Jacek PLoS One Research Article BACKGROUND: Relative blood volume (RBV) changes during hemodialysis (HD) are typically estimated based on online measurements of hematocrit, hemoglobin or total blood protein. The aim of this study was to assess changes in the above parameters during HD in order to compare the potential differences in the RBV changes estimated by individual methods. METHODS: 25 anuric maintenance HD patients were monitored during a 1-week conventional HD treatment. Blood samples were collected from the arterial dialysis blood line at the beginning and at the end of each HD session. The analysis of blood samples was performed using the hematology analyzer Advia 2120 and clinical chemistry analyzer Advia 1800 (Siemens Healthcare). RESULTS: During the analyzed 30 HD sessions with ultrafiltration in the range 0.7–4.0 L (2.5 ± 0.8 L) hematocrit (HCT) increased by 9.1 ± 7.0% (mean ± SD), hemoglobin (HGB) increased by 10.6 ± 6.3%, total plasma protein (TPP) increased by 15.6 ± 9.5%, total blood protein (TBP) increased by 10.4 ± 5.8%, red blood cell count (RBC) increased by 10.8 ± 7.1%, while mean corpuscular red cell volume (MCV) decreased by 1.5 ± 1.1% (all changes statistically significant, p < 0.001). HGB increased on average by 1.5% more than HCT (p < 0.001). The difference between HGB and TBP increase was insignificant (p = 0.16). CONCLUSIONS: Tracking HGB or TBP can be treated as equivalent for the purpose of estimating RBV changes during HD. Due to the reduction of MCV, the HCT-based estimate of RBV changes may underestimate the actual blood volume changes. Public Library of Science 2019-08-12 /pmc/articles/PMC6690539/ /pubmed/31404089 http://dx.doi.org/10.1371/journal.pone.0220764 Text en © 2019 Pstras et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Pstras, Leszek
Debowska, Malgorzata
Wojcik-Zaluska, Alicja
Zaluska, Wojciech
Waniewski, Jacek
Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title_full Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title_fullStr Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title_full_unstemmed Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title_short Hemodialysis-induced changes in hematocrit, hemoglobin and total protein: Implications for relative blood volume monitoring
title_sort hemodialysis-induced changes in hematocrit, hemoglobin and total protein: implications for relative blood volume monitoring
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690539/
https://www.ncbi.nlm.nih.gov/pubmed/31404089
http://dx.doi.org/10.1371/journal.pone.0220764
work_keys_str_mv AT pstrasleszek hemodialysisinducedchangesinhematocrithemoglobinandtotalproteinimplicationsforrelativebloodvolumemonitoring
AT debowskamalgorzata hemodialysisinducedchangesinhematocrithemoglobinandtotalproteinimplicationsforrelativebloodvolumemonitoring
AT wojcikzaluskaalicja hemodialysisinducedchangesinhematocrithemoglobinandtotalproteinimplicationsforrelativebloodvolumemonitoring
AT zaluskawojciech hemodialysisinducedchangesinhematocrithemoglobinandtotalproteinimplicationsforrelativebloodvolumemonitoring
AT waniewskijacek hemodialysisinducedchangesinhematocrithemoglobinandtotalproteinimplicationsforrelativebloodvolumemonitoring