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Associations of cerebral oxygenation with hemoglobin levels evaluated by near-infrared spectroscopy in hemodialysis patients

Author

Listed:
  • Susumu Ookawara
  • Kiyonori Ito
  • Yusuke Sasabuchi
  • Hideyuki Hayasaka
  • Masaya Kofuji
  • Takayuki Uchida
  • Keita Horigome
  • Sojiro Imai
  • Toshiko Akikawa
  • Noriko Wada
  • Satoshi Kiryu
  • Satoru Imada
  • Mitsutoshi Shindo
  • Haruhisa Miyazawa
  • Keiji Hirai
  • Yasushi Onishi
  • Hirofumi Shimoyama
  • Akihisa Watanabe
  • Kaoru Tabei
  • Yoshiyuki Morishita

Abstract

Hemoglobin (Hb) is associated with cerebral oxygenation status owing to its important role of carrying oxygen to systemic tissues. However, data concerning the associations between Hb levels and cerebral regional oxygen saturation (rSO2) of hemodialysis (HD) patients is limited. We aimed to identify these associations to consider a target Hb level for renal anemia management. This study included 375 HD patients. Cerebral rSO2 before HD was monitored using the INVOS 5100c oxygen saturation monitor. Multivariable linear regression analysis showed that cerebral rSO2 was independently associated with natural logarithm (Ln)-HD duration (standardized coefficient: -0.36), mean blood pressure (standardized coefficient: 0.13), pH (standardized coefficient: -0.10), serum albumin (standardized coefficient: 0.14), presence of diabetes mellitus (standardized coefficient: -0.20), and Hb level (standardized coefficient: 0.29). Furthermore, a generalized linear model with restricted cubic spline function was used to investigate the non-linear association between cerebral rSO2 and Hb levels. In the multivariable analysis for the adjustment with Ln-HD duration, mean blood pressure, pH, serum albumin, and presence of diabetes mellitus, a linear relationship was demonstrated between the two variables (p for linearity = 0.79). Hb levels revealed the positive and significant association with cerebral rSO2 in this study. Moreover, the relationship between cerebral rSO2 and Hb level was proven to be linear. Therefore, the target Hb level in renal anemia management would be considered to be the upper limits for the appropriate management of renal anemia by previous guidelines and position statement from the viewpoint of maintaining cerebral oxygenation in HD patients.

Suggested Citation

  • Susumu Ookawara & Kiyonori Ito & Yusuke Sasabuchi & Hideyuki Hayasaka & Masaya Kofuji & Takayuki Uchida & Keita Horigome & Sojiro Imai & Toshiko Akikawa & Noriko Wada & Satoshi Kiryu & Satoru Imada & , 2020. "Associations of cerebral oxygenation with hemoglobin levels evaluated by near-infrared spectroscopy in hemodialysis patients," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-11, August.
    • Handle: RePEc:plo:pone00:0236720
    DOI: 10.1371/journal.pone.0236720
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    References listed on IDEAS

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    1. Kiyonori Ito & Susumu Ookawara & Yuichiro Ueda & Sawako Goto & Haruhisa Miyazawa & Hodaka Yamada & Taisuke Kitano & Mitsunobu Shindo & Yoshio Kaku & Keiji Hirai & Masashi Yoshida & Taro Hoshino & Aoi , 2015. "Factors Affecting Cerebral Oxygenation in Hemodialysis Patients: Cerebral Oxygenation Associates with pH, Hemodialysis Duration, Serum Albumin Concentration, and Diabetes Mellitus," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-11, February.
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