Exploring haemodynamics of haemodialysis using extrema points analysis model

Eldehni, Mohamed Tarek and Odudu, Aghogho and McIntyre, Christopher William (2013) Exploring haemodynamics of haemodialysis using extrema points analysis model. Theoretical Biology and Medical Modelling, 10 . 33/1-33/10. ISSN 1742-4682

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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.

Item Type: Article
Additional Information: Copy of Creative Commons Attribution License must accompany any deposit
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Medical Sciences and Graduate Entry Medicine
Identification Number: https://doi.org/10.1186/1742-4682-10-33
Depositing User: de Sousa, Mrs Shona
Date Deposited: 01 Apr 2014 07:54
Last Modified: 15 Sep 2016 00:30
URI: http://eprints.nottingham.ac.uk/id/eprint/2793

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