ArticleKidney international reports2021
Exploring the Link Between Hepatic Perfusion and Endotoxemia in Hemodialysis.
Article in Kidney international reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- The hemodynamic cost of intermittent hemodialysis and systemic organ stunning.Renal failure · 2026Review
- Post-Hemodialysis Flow-Dependent Hepatic Function Impairment in Individuals With End Stage Kidney Disease and Chronic Inflammation.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Article
- Coronary Artery Disease and Intradialytic Myocardial Ischemia in Hemodialysis: An Exploratory Study Using Intradialytic Imaging.Kidney medicine · 2025Article
- Dialysis and cognitive impairment.Nature reviews. Nephrology · 2025Review
- The safety of indocyanine green in patients with advanced chronic kidney disease or kidney transplantation: a scoping review.Annals of medicine and surgery (2012) · 2025Review
- The systemic inflammation response index (SIRI) is associated with all-cause and cardiovascular mortality in maintenance hemodialysis patients.Archives of medical science : AMS · 2025Article
- The liver's dilemma: sensing real danger in a sea of PAMPs: the (arterial) sinusoidal segment theory.Frontiers in immunology · 2024Review
- Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease.Frontiers in pharmacology · 2022Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe liver receives gut-derived endotoxin via the portal vein, clearing it before it enters systemic circulation. Hemodialysis negatively impacts the perfusion and function of multiple organs systems. Dialysate cooling reduces hemodialysis-induced circulatory stress and protects organs from ischemic injury. This study examined how hemodialysis disrupts liver hemodynamics and function, its effect on endotoxemia, and the potential protective effect of dialysate cooling.
methodsFifteen patients were randomized to receive either standard (36.5°C dialysate temperature) or cooled (35.0°C) hemodialysis first in a two-visit crossover trial. We applied computed tomography (CT) liver perfusion imaging to patients before, 3 hours into and after each hemodialysis session. We measured hepatic perfusion and perfusion heterogeneity. Hepatic function was measured by indocyanine green (ICG) clearance. Endotoxin levels in blood throughout dialysis were also measured.
resultsDuring hemodialysis, overall liver perfusion did not significantly change, but portal vein perfusion trended towards increasing (
conclusionHemodialysis redistributes liver perfusion, attenuates hepatic function, and results in endotoxemia. Higher endotoxin levels in end-stage renal disease (ESRD) patients may result from the combination of decreased hepatic clearance function and increasing fraction of liver perfusion coming from toxin-laden portal vein during hemodialysis. The protective potential of dialysate cooling should be explored further in future research studies.
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