Continuous Monitoring of Advanced Hemodynamic Parameters during Hemodialysis Demonstrated Early Variations in Patients Experiencing Intradialytic Hypotension

Yotam Kolben, Ittamar Gork, David Peled, Shani Amitay, Peleg Moshel, Nir Goldstein, Arik Ben Ishay, Meir Fons, Michael Tabi, Arik Eisenkraft*, Yftach Gepner, Dean Nachman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Intradialytic hypotension (IDH) is a severe complication of hemodialysis (HD) with a significant impact on morbidity and mortality. In this study, we used a wearable device for the continuous monitoring of hemodynamic vitals to detect hemodynamic changes during HD and attempted to identify IDH. End-stage kidney disease patients were continuously monitored 15 min before starting the session and until 15 min after completion of the session, measuring heart rate (HR), noninvasive cuffless systolic and diastolic blood pressure (SBP and DBP), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR). Data were analyzed retrospectively and included comparing BP measured by the wearable devices (recorded continuously every 5 s) and the cuff-based devices. A total of 98 dialysis sessions were included in the final analysis, and IDH was identified in 22 sessions (22.5%). Both SBP and DBP were highly correlated (r > 0.62, p < 0.001 for all) between the wearable device and the cuff-based measurements. Based on the continuous monitoring, patients with IDH had earlier and more profound reductions in SBP and DBP during the HD treatment. In addition, nearly all of the advanced vitals differed between groups. Further studies should be conducted in order to fully understand the potential of noninvasive advanced continuous monitoring in the prediction and prevention of IDH events.

Original languageEnglish
Article number1177
JournalBiomedicines
Volume12
Issue number6
DOIs
StatePublished - Jun 2024

Funding

FundersFunder number
Biobeat Technologies Ltd.

    Keywords

    • end-stage kidney disease
    • hemodialysis
    • intradialytic hypotension
    • noninvasive blood pressure
    • photoplethysmography
    • remote patient monitoring

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