Exploring haemodynamics of haemodialysis using extrema points analysis model

Eldehni, Mohamed Tarek; Odudu, Aghogho; McIntyre, Christopher William

Abstract

Background: Haemodialysis is a form of renal replacement therapy used to treat
patients with end stage renal failure. It is becoming more appreciated that
haemodialysis patients exhibit higher rates of multiple end organ damage
compared to the general population. There is also a strong emerging evidence that
haemodialysis itself causes circulatory stress. We aimed at examining
haemodynamic patterns during haemodialysis using a new model and test that
model against a normal control.
Methods: We hypothesised that blood pressures generated by each heart beat
constantly vary between local peaks and troughs (local extrema), the frequency and
amplitude of which is regulated to maintain optimal organ perfusion. We also
hypothesised that such model could reveal multiple haemodynamic aberrations
during HD. Using a non-invasive cardiac output monitoring device (Finometer®) we
compared various haemodynamic parameters using the above model between a
haemodialysis patient during a dialysis session and an exercised normal control after
comparison at rest.
Results: Measurements yielded 29,751 data points for each haemodynamic
parameter. Extrema points frequency of mean arterial blood pressure was higher in
the HD subject compared to the normal control (0.761Hz IQR 0.5-0.818 vs 0.468Hz
IQR 0.223-0.872, P < 0.0001). Similarly, extrema points frequency of systolic blood
pressure was significantly higher in haemodialysis compared to normal. In contrary,
the frequency of extrema points for TPR was higher in the normal control compared
to HD (0.947 IQR 0.520-1.512 vs 0.845 IQR 0.730-1.569, P < 0.0001) with significantly
higher amplitudes.
Conclusion: Haemodialysis patients potentially exhibit an aberrant haemodynamic
behaviour characterised by higher extrema frequencies of mean arterial blood
pressure and lower extrema frequencies of total peripheral resistance. This, in
theory, could lead to higher variation in organ perfusion and may be detrimental to vulnerable vascular beds.

Citation

Eldehni, M. T., Odudu, A., & McIntyre, C. W. Exploring haemodynamics of haemodialysis using extrema points analysis model. Theoretical Biology and Medical Modelling, 10, Article 33. https://doi.org/10.1186/1742-4682-10-33

• Journal Article Type: Article
• Deposit Date: Apr 1, 2014
• Journal: Theoretical Biology and Medical Modelling
• Print ISSN: 1742-4682
• Electronic ISSN: 1742-4682
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Article Number: 33
• DOI: https://doi.org/10.1186/1742-4682-10-33
• Public URL: https://nottingham-repository.worktribe.com/output/715115
• Publisher URL: http://www.tbiomed.com/content/10/1/33
• Additional Information: Copy of Creative Commons Attribution License must accompany any deposit