THE HAEMODYNAMIC RESPONSE TO CHRONIC RENAL FAILURE AS STUDIED IN THE AZOTAEMIC STATE

Fifty-nine haemodynamic studies were performed in 21 patients with chronic renal failure, usually on a day following at least 6 hours of haemodialysis. A miniature polyethylene tubing was “floated” into the right ventricle under manometric guidance without X-ray control. Indocyanine green was injected into the right ventricle for cardiac output estimations. Cardiac index, stroke volume, total peripheral resistance and mean arterial pressure were all found to be high. The total blood volume measured with 123 I isotope was not significantly expanded. Three patients with acute pulmonary oedema had normal central venous and right atrial pressures, showing that pulmonary capillary permeability is probably the principal factor in the padiogenesis of the “uraemic lung”, and that in these circumstances monitoring of central venous pressure is not reliable in warning the physician of impending pulmonary oedema. For this purpose it was useful to measure blood volume and right ventricular pressure.