Effct of hemodialysis on brain metabolism

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The effect of hemodialysis on intracellular pH in brain tissue was studied in ten uremic hares weighing about 2 kg. Uremia was induced by right nephrectomy and left subtotal nephrectomy. Dialysis was done with a small-sized hollow fiber unit and bicarbonate dialysate. The pH changes was monitored by use of 31 P nuclear magnetic resonance spectroscopy, using JEOL FX-200 NMR spectrometer (JOEL, Tokyo), operating at 80.75 MHz for 31 P-NMR. Each Spectrum was acquired by accumulation of 600 pulses with a pulse delay of 4.8 microsec. and acquisition time of about 0.5 seconds. Dialysis of 180 minutes with a blood flow rate between 200 ml/hr and 414 ml/hr was found to lower plasma urea and creatinine concentrations. However, no significant changes of the relative concentrations of the energy rich phosphates ATP, phosphomonoester, phosphodiester, inorganic phosphate and the pH were found in the front parietal brain. There was a possibility that the extent of uremia and the efficacy of dialysis in this experiment was insufficient to induce brain water and electrolyte metabolism alterations. MRS was a powerful new tool for studying effects of various methods of dialysis on brain pH and energy metabolism in vivo.