| Theme | Erythropoietin Up-To-Date | |
|---|---|---|
| Title | Effects of renal anemia on central nervous system | |
| Publish Date | 2003/04 | |
| Author | Kazuhiko Tsuruya | Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University |
| Author | Kiichiro Fujisaki | Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University |
| Author | Hideki Hirakata | The Kidney Care Unit, Faculty of Medicine, Kyushu University |
| [ Summary ] | Hematocrit (Ht) is a major determinant factor for cerebral blood flow (CBF), i.e., brain function, especially when it is below 30%. In our previous study using positron emission tomography, it was revealed that cerebral oxygen metabolism was severely depressed in chronic hemodialysis patients, even after anemia was corrected to 30% with rHuEPO. Ht correlated with both CBF and arterial oxygen content. An optimal Ht level for maximum oxygen supply to the brain was estimated to be around 35%. The rise in Ht causes an increase in whole blood viscosity, leading to a decrease in blood flow, which may cause ischemic brain injuries. When a sudden drop in blood pressure occurs, it causes hemodynamically mediated brain infarction. This pathogenetic mechanism should be considered in patients who have severely stenotic lesions in the main trunks of both the extra- and intra-cerebral arteries. In this content, anemia should be managed to protect brain circulation in the patients with chronic renal failure. |
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