Electrophysiological Response to Dialysis: The Role of Dialysate Potassium Content and Profiling

Santoro, Antonio; Mancini, Elena; Gaggi, Rossella; Cavalcanti, Silvio; Severi, Stefano; Cagnoli, L; Badiali, Fabio; Perrone, B; London, G; Fessy, H.; Mercadal, Lucile; Grandi, Fábio

doi:10.1159/000085691

Cited by 25 publications

(23 citation statements)

References 12 publications

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“…For stable dialysis patients, a dialysate potassium level of 2 mmol/l maintains the plasma levels below 6 mmol/l and avoids post-dialysis hypokalaemia. Patients with cardiac disease and arrythmias may need higher potassium levels in the dialysis fl uid (3-3.5 mmol/l), coupled with frequent monitoring of plasma potassium levels as a fall in serum potassium predisposes the patient to an increased QT dispersion which may be ameliorated by potassium profi ling [35,36] .…”

Section: Potassiummentioning

confidence: 99%

The Importance of Water Quality and Haemodialysis Fluid Composition

Hoenich¹,

Ronco²,

Levin³

2005

Blood Purif

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Treatment of renal failure by haemodialysis uses dialysis fluid to facilitate the normalization of electrolyte and acid base abnormalities and the removal of low molecular weight uraemic compounds present in the plasma such as urea. The dialysis fluid is a continuously produced blend of treated tap water and a concentrated solution containing electrolytes, buffer, and glucose. The water used originates as drinking water but undergoes additional treatment. Recent surveys have indicated that the chemical and microbiological content of such water frequently fails to meet the requirements of established standards, and its bacterial content arising from the presence of a biofilm in the water distribution network or the hydraulic circuit of the dialysis machine is a contributory factor to the chronic inflammatory state in patients undergoing regular dialysis. The composition of the dialysis fluid plays an important role in the modulation of complications associated with end-stage renal disease, as well as those associated with the treatment itself. The avoidance of complications arising from water contaminants requires a constant and vigorous attention to water quality, whilst with the composition of electrolytes and buffer there is a trend towards greater individualization to provide a high degree of treatment tolerance.

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Section: Potassiummentioning

confidence: 99%

The Importance of Water Quality and Haemodialysis Fluid Composition

Hoenich¹,

Ronco²,

Levin³

2005

Blood Purif

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“…Given that PVBs are frequent in hemodialysis patients [23], [24], and occur much more frequently during treatment than after [2], monitoring of PVB rate can have clinical significance [4]. In the present method, PVB detection has not been treated separately, but it is performed in the same way as the detection of any beat, i.e., a beat is detected as long as it is found within the tolerance interval [η c,0 , η c,1 ] centered around the expected occurrence times.…”

Section: B Methodological Aspectsmentioning

confidence: 99%

Extracting a Cardiac Signal From the Extracorporeal Pressure Sensors of a Hemodialysis Machine

Holmer¹,

Sandberg

Solem³

et al. 2015

IEEE Trans. Biomed. Eng.

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Although patients undergoing hemodialysis treatment often suffer from cardiovascular disease, monitoring of cardiac rhythm is not performed on a routine basis. Without requiring any extra sensor, this study proposes a method for extracting a cardiac signal from the built-in extracorporeal venous pressure sensor of the hemodialysis machine. The extraction is challenged by the fact that the cardiac component is much weaker than the pressure component caused by the peristaltic blood pump. To further complicate the extraction problem, the cardiac component is difficult to separate when the pump and heart rates coincide. The proposed method estimates a cardiac signal by subtracting an iteratively refined blood pump model signal from the signal measured at the extracorporeal venous pressure sensor. The method was developed based on simulated pressure signals, and evaluated on clinical pressure signals acquired during hemodialysis treatment. The heart rate estimated from the clinical pressure signal was compared to that derived from a photoplethysmographic reference signal, resulting in a difference of 0.07 ± 0.84 beats/min. The accuracy of the heartbeat occurrence times was studied for different strengths of the cardiac component, using both clinical and simulated signals. The results suggest that the accuracy is sufficient for analysis of heart rate and certain arrhythmias.

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“…This has been related to the appearance of arrhythmias or to the worsening of pre-existing arrhythmias: induction or worsening of ventricular extrasystoles, QT prolongation (Cupisti , 1999, , Floccari et al, 2004 and onset of paroxysmal atrial fibrillation have been described. Acetate Free Biofiltration with Potassium Profiled Dialysate (AFB-K) is a haemodialysis technique that attempts to obviate this problem, avoiding sudden potassium reductions during the haemodialysis session, but with due correction of the hyperkalaemia of the patients (Santoro et al, 2005).…”

Section: Arrhythmia In Patients On Dialysismentioning

confidence: 99%