Factors associated with elevated blood lactate levels in patients undergoing maintenance hemodialysis

• Published in: Journal of artificial organs Vol. 26; no. 3; pp. 212 - 219
• Main Authors: Hori, Kazuyoshi, Uchida, Yasutaka, Kokubo, Kenichi, Matsuzawa, Naoya, Kamegamori, Anna, Iizuka, Tomoya, Saito, Yusuke, Shiota, Kenji, Kidooka, Satoshi, Inoue, Masahiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.09.2023; Springer Nature B.V
• Subjects: Adequacy; Ankle; Biomedical Engineering and Bioengineering; Blood; Blood circulation; Blood vessels; C-reactive protein; Cardiac Surgery; Creatinine; Dialysis; Extremities; Heart; Hemodialysis; Inflammation; Lactic acid; Leukocytes; Maintenance; Medicine; Medicine & Public Health; Nephrology; Nutritional status; Original Article; Partial pressure; Peripheral blood; Ventricle; Blood lactate; C-reactive protein; Chronic inflammatory response; Elderly hemodialysis patients
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s10047-022-01355-y

Factors associated with chronic elevation of the blood lactate levels in patients undergoing chronic maintenance hemodialysis (hereinafter, hemodialysis patients) have not yet been thoroughly investigated. The purpose of the present study was to clarify factors associated with elevated blood lactate levels in hemodialysis patients. We divided the hemodialysis patients into two groups according the blood lactate levels (the high blood lactate group [> 2 mmol/L] and normal blood lactate group), and conducted a retrospective comparison of the following items between the two groups: (1) the creatinine generation rate (%CGR) and the geriatric nutrition risk index (GNRI) as indices of the nutritional status; (2) the left ventricular ejection fraction (LVEF) and E/A, an indicator of diastolic function; (3) the ankle–brachial index (ABI) and transcutaneous partial pressure of oxygen as indices of the adequacy of circulation in the peripheral blood vessels of the lower extremities; (4) the white blood cell count and serum level of C-reactive protein (CRP) before dialysis as markers of an inflammatory state. The mean age and serum CRP level were significantly higher in the high blood lactate group than in the normal blood lactate group. There were no significant differences in the markers of the nutritional status, cardiac function, or adequacy of circulation in the peripheral blood vessels of the lower extremities between the two groups. Advanced age and a state of chronic inflammation appear to be associated with elevated blood lactate levels in patients undergoing chronic maintenance hemodialysis.