Quantification of autonomic nervous activity by heart rate variability and approximate entropy in high ultrafiltration rate during hemodialysis

Tsuji, Yoshihiro; Suzuki, Naoki; Hitomi, Yasumasa; Yoshida, Toshiko; Mizuno‐Matsumoto, Yuko

doi:10.1007/s10157-016-1305-5

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…Sample entropy went down in both subgroups but did not reach statistical significance. Nonlinear parameters were widely used in recent works to indicate ANS function and predict outcomes in HD patients ( Ferrario et al, 2015b ; Tsuji et al, 2017 ; Liu et al, 2020 ). Further investigation with a larger sample size is required.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

et al. 2022

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Background: Autonomic nervous regulation plays a critical role in end-stage kidney disease (ESKD) patients with cardiovascular complications. However, studies on autonomic regulation in ESKD patients are limited to heart rate variability (HRV) analysis. Skin sympathetic nerve activity (SKNA), which noninvasively reflects the sympathetic nerve activity, has not been used in ESKD patients.Methods: Seventy-six patients on maintenance hemodialysis (MHD) treatment (a 4-h HD session, three times a week) were enrolled. Utilizing a noninvasive, single-lead, high-frequency recording system, we analyzed the dynamic change in HRV parameters and SKNA during HD. The different characteristics between the subgroups divided based on interdialytic weight gain (IDWG, <3 kg or ≥3 kg) were also demonstrated.Results: After the HD, values for heart rate (75.1 ± 11.3 to 80.3 ± 12.3 bpm, p < 0.001) and LF/HF (1.92 ± 1.67 to 2.18 ± 2.17, p = 0.013) were significantly higher than baseline. In subgroup analysis, average voltage of skin sympathetic nerve activity (aSKNA) in IDWG ≥3 kg group was lower than the IDWG <3 kg group at the end of MHD (1.06 ± 0.30 vs 1.32 ± 0.61 μV, p = 0.046). Moreover, there was a linear correlation between mean heart rate (HR) and aSKNA in low IDWG patients (p < 0.001), which was not found in high IDWG patients. At the 1-year follow-up, high IDWG patients had a higher incidence of cardiovascular hospitalization (p = 0.046).Conclusions: In MHD patients, a gradual activation of sympathetic nerve activity could be measured by HRV and aSKNA. A lower aSKNA at the end of HD and a loss of HR-aSKNA correlation in overhydrated patients were observed. Extensive volume control is promising to improve the autonomic nervous function and clinical outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

et al. 2022

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“…Therefore, the intensity of exercise in this study was predicted to be lower than the anaerobic metabolic threshold, and α 1 in 30% and 50% of IHG would not have changed. In a study of ApEn in patients with chronic kidney disease, the increase in ApEn was considered to be due to the failure of the autonomic nervous response 35 ) . Based on these findings, the present study with healthy participants is expected to show regular changes while maintaining 1/f fluctuation as a response before and after IHG.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of autonomic nervous system responses during isometric handgrip exercise using nonlinear analysis of heart rate variability

et al. 2022

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[Purpose] The purpose of this study was to examine, using a plethysmogram of the fingertips, autonomic responses at motor intensities of 30% or 50% of maximum voluntary contraction (MVC) during isometric handgrip exercise (IHG). [Participants and Methods] The participants of this study were 15 healthy persons. The finger volume pulse wave of each participant was measured continuously, using a BACS Advance equipment (TAOS Co.), for a total of 17 minutes: 5 minutes before IHG (Pre), 2 minutes during IHG (IHG), the first 5 minutes after IHG (Post 5), and then the second 5 minutes after IHG (Post 10). To evaluate autonomic nervous system activity, we used the Detrended fluctuation analysis (DFA) and Approximate Entropy (ApEn). [Results] During IHG, the pulse rate was significantly higher and the ApEn value was significantly lower than during the other periods of measurement. Compared to other analyzed parameters, ApEn decreased during IHG, but returned to its initial Pre period level during the Post 5 period. The α 1 value derived from the DFA analysis remained at a value of 1 during each measurement time point, indicating the absence of malfunctions in autonomic response. [Conclusion] Isometric handgrip exercise with 30% MVC seemed to be useful for the assessment of autonomic nervous system response.

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“…The accuracy of the ultrafiltration system, which is configured to remove/deliver excess fluid from/to the dialyser, is crucial for patients [ 14 ], and it must be ensured that the relative deviation of the measurement value from the set value is not greater than ±1%, or the absolute error is less than ±30 mL/h. The ultrafiltration control system of currently marketed dialysis machines can be divided into two categories: flow sensor system and balancing chamber system.…”

Section: Discussionmentioning

confidence: 99%

In vivo and in vitro performance of a China-made hemodialysis machine: a multi-center prospective controlled study

et al. 2017

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Objective To evaluate the in vivo and in vitro performance of a China-made dialysis machine (SWS-4000). Methods This was a multi-center prospective controlled study consisting of both long-term in vitro evaluations and cross-over in vivo tests in 132 patients. The China-made SWS-4000 dialysis machine was compared with a German-made dialysis machine (Fresenius 4008) with regard to Kt/V values, URR values, and dialysis-related adverse reactions in patients on maintenance hemodialysis, as well as the ultrafiltration rate, the concentration of electrolytes in the proportioned dialysate, the rate of heparin injection, the flow rate of the blood pump, and the rate of malfunction. Results The Kt/V and URR values at the 1st and 4th weeks of dialysis as well as the incidence of adverse effects did not differ between the two groups in cross-over in vivo tests ( P > 0.05). There were no significant differences between the two groups in the error values of the ultrafiltration rate, the rate of heparin injection or the concentrations of electrolytes in the proportioned dialysate at different time points under different parameter settings. At weeks 2 and 24, with the flow rate of the blood pump set at 300 mL/min, the actual error of the SWS-4000 dialysis machine was significantly higher than that of the Fresenius 4008 dialysis machine ( P < 0.05), but there was no significant difference at other time points or under other settings ( P > 0.05). The malfunction rate was higher in the SWS-4000 group than in the Fresenius 4008 group ( P < 0.05). Conclusions The in vivo performance of the SWS-4000 dialysis machine is roughly comparable to that of the Fresenius 4008 dialysis machine; however, the malfunction rate of the former is higher than that of the latter in in vitro tests. The stability and long-term accuracy of the SWS-4000 dialysis machine remain to be improved.

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Quantification of autonomic nervous activity by heart rate variability and approximate entropy in high ultrafiltration rate during hemodialysis

Abstract: Removing water from these subjects would promote sustained sympathetic nervous overactivity. These findings indicate that the UFR during HD needs to be set at ≤15 ml/h/kg.

Cited by 8 publications

References 14 publications

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

Evaluation of autonomic nervous system responses during isometric handgrip exercise using nonlinear analysis of heart rate variability

In vivo and in vitro performance of a China-made hemodialysis machine: a multi-center prospective controlled study

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