Transcranial Doppler Measurement of Middle Cerebral Artery Blood Flow Velocity in Patients with End-stage Renal Disease Referred for Hemodialysis Due to Chronic Glomerulonephritis and Diabetic Nephropathy.
10.2185/jjrm.50.108
- VernacularTitle:慢性糸球体腎炎および糖尿病性腎症由来の慢性血液透析患者における経頭蓋骨超音波ドップラーを用いた中大脳動脈血流速度の測定
- Author:
Gen KURAMOCHI
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
2001;50(2):108-113
- CountryJapan
- Language:Japanese
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Abstract:
It is known that the cerebral circulation is regulated spontaneously and always keep blood flow constant despite changes in perfusion pressure. This phenomenon has been called the autoregulation of cerebral blood flow. However, there is still considerable controversy regarding the influence of blood viscosity upon cerebral blood flow. Several studies have reported that in hemodialysis patients, the velocity of middle cerebra artery (MCA) blood flow decreased after hemodialysis, resulting from the decrease in body fluid and the increase in blood viscosity. In the present study, we evaluated changes in MCA blood flow velocity by hemodialysis in the patients with end-stage re -nal disease referred for hemodialysis due to chronic glomerulonephritis (CGN group) and diabetic nephropathy (DN group). No stenoses of the carotid artery were comfi rmed by ultrasonography in all subjects. We measured MCA blood flow velocity before and after hemodialysis using a 2-MHz pulsed-wave transcranial Doppler instrument with on-line spectrum analysis. Additionally, the measurements of mean blood pressure, body weight, hematocrit levels and arterial blood gas were made simultaneously. In the CGN and DN groups, mean MCA blood flow velocity was 52-56cm/sec and 49-53 cm/sec before hemodialysis and 51-53cm/sec and 51-53cm/sec after hemodialysis, respectively. No significant decreases in MCA blood flow velocity after hemodialysis were found in both groups, though body weight in both groups and mean blood pressure in the DN group alone decreased while pH, HCO3-, and Ht levels in both groups increased significantly. PCO2 and pO2 levels remained unchanged. Also, no significant differences were found between both groups in the changes in MCA blood flow velocity. Pulsatility and resistive indices in the DN group were relatively higher than those in the CGN group. This result suggests the more progression of arteriosclerotic changes in MCA in the DN group compared with those in the CGN group.
