Differences in heart rate variability during haemodialysis and haemofiltration.
BACKGROUND
The aim of our study was to evaluate whether convective (haemofiltration, Hf) and diffusive (haemodialysis, Hd) dialysis techniques induce different patterns of long- and short-term autonomic adjustments in haemodynamically stable dialysis patients.


METHODS
Ten haemodynamically stable Hd patients were studied. Each patient underwent a block of six Hd sessions, then was switched to six Hf. During the last session of each dialytic treatment, continuous beat to beat measurements of systolic arterial pressure (SAP) and heart rate (HR) were performed. Spectral analysis of heart rate variability (HRV) was made before and during the treatment to evaluate the modification of autonomic nervous system activity.


RESULTS
Baseline values of plasma sodium, body weight, HR and SAP were not different for the two considered methods of dialysis, while the baseline values of normalized LF were significantly higher in Hf as compared to Hd and the opposite was observed for HF powers (P < 0.001). Sodium balance and body weight loss per hour did not differ between Hd and Hf while body temperature was kept constant in all sessions. Throughout the dialytic procedures, with both techniques, SAP was constant, while HR diminished from the first hour till the end of the procedure (P < 0.05). An increase in LF (and decrease in HF) was noticed only in the case of Hd, considering normalized units (P < 0.05). These selective changes were maintained also during the recovery after the procedure.


CONCLUSIONS
The spectral analysis of RR interval variability during Hd and Hf suggests a potential autonomic advantage with Hf, to be added to the well-recognized intrinsic greater haemodynamic stability.
Genovesi
Simonetta
S
Clinica Nefrologica - Università degli studi di Milano Bicocca-Ospedale S Gerardo, Milan, Italy. simonetta.genovesi@unimib.it
Bracchi
Oscar
O
Fabbrini
Paolo
P
Luisetto
Elena
E
Viganò
Maria Rosa
MR
Lucini
Daniela
D
Malacarne
Mara
M
Stella
Andrea
A
Pagani
Massimo
M
D000368:Aged; D001835:Body Weight; D004058:Diffusion; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009991:Oscillometry; D006435:Renal Dialysis / Q000379:methods*; D012964:Sodium / Q000097:blood / Q000378:metabolism; D013599:Systole
D012964:Sodium