Efficacy of Hemocontrol Biofeedback System in Intradialytic Hypotension-Prone Hemodialysis Patients

Abstract

We conducted a study to determine whether the hemocontrol biofeedback system (HBS) can improve intradialytic hypotension (IDH) in hypotension-prone hemodialysis (HD) patients compared with conventional HD. In this multicenter prospective crossover study, 60 hypotension-prone patients were serially treated by conventional HD for 8 weeks (period A), by HD with hemoscan blood volume monitoring for 2 weeks (period B0), and by HBS HD for 8 weeks (period B1). The number of sessions complicated by symptomatic IDH during 24 HD sessions (14.9±5.8 sessions, 62.1% in period A vs 9.2±7.2 sessions, 38.4% in period B1, P<0.001) and the number of IDH-related nursing interventions in a session (0.96±0.66 in period A vs 0.56±0.54 in period B1, P<0.001) significantly decreased in period B1 than in period A. Recovery time from fatigue after dialysis was significantly shorter in period B1 than in period A. The patients with higher post-dialysis blood pressure, lower difference between pre- and post-dialysis blood pressure, less frequent IDH, and higher pre- and post-dialysis body weight in period A responded better to HBS in period B1 in regard to the reduction of IDH. In conclusion, HBS may improve the patient tolerability to HD by reducing the IDH frequency and promoting faster recovery from fatigue after dialysis.Graphical Abstract

The Effectiveness of an Educational Intervention on Fatigue in Hemodialysis Patients: A Randomized Controlled Trial

“…Also present study shows that there are no statistically significant difference between pre, post test and follow up. These study in line with Gil et al [32] Found that hemoglobin (g/dL) levels did not differ between period A and period B1 mean score (10.6±1.2, 10.7±1.4, p= 0.767).…”

“… The researcher started the data collection and implementation of the program from the November 2013 to December 2013.  The patient assessment sheet was filled by the researcher through personal interview, within [30][31][32][33][34][35][36][37][38][39][40] minutes, the purpose of the study was explained to them and an informed consent to participate in the study was taken.  Intervention program.…”

Effect of Mealtime During Hemodialysis on Patients’ Complications

“…8 It has been reported in up to 60% of dialysis sessions in some previous studies. 3,9 This complication is usually associated with symptoms of dizziness, headache, weakness, nausea, vomiting, muscle cramps, and fatigue. 2,10 …”

“…The main factor in intradialytic hypotension is the reduction of circulating blood volume followed by huge ultrafiltration and sodium uptake, subsequently the imbalance between the ultrafiltration rate and the plasma refilling rate. 9 Other factors include: rapid reduction in plasma osmolality, rapid liquid uptake to achieve dry weight, lack of appropriate measurement of dry weight in hemodialysis patients, eating before and during hemodialysis. 9,12 …”

Complicações Em Pacientes Renais Crônicos Submetidos À Hemodiálise

“…Essa é uma resposta compensatória cardiovascular, que ocorre quando o ritmo da ultrafiltração ultrapassa a capacidade do preenchimento vascular (9) . A remoção rápida de substâncias osmoticamente ativas e o retardo do equilíbrio nos compartimentos intracelulares causam diminuição transitória na osmolalidade do plasma, justificando os episódios de hipotensão (10) .…”