An analysis of frequency of continuous blood pressure variation and haemodynamic responses during haemodialysis

Latha Gullapudi, Venkata R., White, Kelly, Stewart, Jill ORCID: https://orcid.org/0000-0002-6482-897X , Stewart, Paul ORCID: https://orcid.org/0000-0001-8902-1497 , Eldehni, Mohammed T., Taal, Maarten W. and Selby, Nicholas M. (2022) An analysis of frequency of continuous blood pressure variation and haemodynamic responses during haemodialysis. Blood Purification, 51 (5). pp. 435-449.

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Abstract

Background: Higher beat-to-beat blood pressure (BP) variation during haemodialysis (HD) has been shown to be associated with elevated cardiac damage markers and white matter ischaemic changes in the brain suggesting relevance to end-organ perfusion. We aimed to characterize individual patterns of BP variation and associated haemodynamic responses to HD.

Methods: Fifty participants underwent continuous non-invasive haemodynamic monitoring during HD and BP variation were assessed using extrema point (EP) frequency analysis. Participants were divided into those with a greater proportion of low frequency (LF, n = 21) and high frequency (HF, n = 22) of BP variation. Clinical and haemodynamic data were compared between groups.

Results: Median EP frequencies for mean arterial pressure (MAP) of mid-week HD sessions were 0.54 Hz (interquartile range 0.18) and correlated with dialysis vintage (r = 0.32, p = 0.039), NT pro-BNP levels (r = 0.32, p = 0.038), and average real variability (ARV) of systolic BP (r = 0.33, p = 0.029), ARV of diastolic BP (r = 0.46, p = 0.002), and ARV of MAP (r = 0.57, p #x3c; 0.001). In the LF group, MAP positively correlated with cardiac power index (CPI) in each hour of dialysis, but not with total peripheral resistance index (TPRI). In contrast, in the HF group, MAP correlated with TPRI in each hour of dialysis but only with CPI in the first hour.

Conclusions: EP frequency analysis of continuous BP monitoring during dialysis allows assessment of BP variation and categorization of individuals into low- or high-frequency groups, which were characterized by different haemodynamic responses to dialysis. This may assist in improved individualization of dialysis therapy.

Item Type:	Article
Journal / Publication Title:	Blood Purification
Publisher:	Karger
ISSN:	1421-9735
Departments:	Institute of Engineering, Computing and Advanced Manufacture
Depositing User:	Paul Stewart
Date Deposited:	04 May 2023 11:26
Last Modified:	13 Jan 2024 13:17
URI:	https://insight.cumbria.ac.uk/id/eprint/7074

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