Exploring haemodynamics of haemodialysis using extrema points analysis model

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 e...

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Main Authors: Eldehni, Mohamed Tarek, Odudu, Aghogho, McIntyre, Christopher William
Format: Article
Published: BioMed Central 2013
Online Access:https://eprints.nottingham.ac.uk/2793/
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author Eldehni, Mohamed Tarek
Odudu, Aghogho
McIntyre, Christopher William
author_facet Eldehni, Mohamed Tarek
Odudu, Aghogho
McIntyre, Christopher William
author_sort Eldehni, Mohamed Tarek
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-27932020-05-04T16:36:56Z https://eprints.nottingham.ac.uk/2793/ Exploring haemodynamics of haemodialysis using extrema points analysis model Eldehni, Mohamed Tarek Odudu, Aghogho McIntyre, Christopher William 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. BioMed Central 2013-05-16 Article PeerReviewed Eldehni, Mohamed Tarek, 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 http://www.tbiomed.com/content/10/1/33 doi:10.1186/1742-4682-10-33 doi:10.1186/1742-4682-10-33
spellingShingle Eldehni, Mohamed Tarek
Odudu, Aghogho
McIntyre, Christopher William
Exploring haemodynamics of haemodialysis using extrema points analysis model
title Exploring haemodynamics of haemodialysis using extrema points analysis model
title_full Exploring haemodynamics of haemodialysis using extrema points analysis model
title_fullStr Exploring haemodynamics of haemodialysis using extrema points analysis model
title_full_unstemmed Exploring haemodynamics of haemodialysis using extrema points analysis model
title_short Exploring haemodynamics of haemodialysis using extrema points analysis model
title_sort exploring haemodynamics of haemodialysis using extrema points analysis model
url https://eprints.nottingham.ac.uk/2793/
https://eprints.nottingham.ac.uk/2793/
https://eprints.nottingham.ac.uk/2793/