Abstract: FR-PO0474
Monitoring Central Blood Pressure During Hemodialysis with Dynamic Sodium and Ultrafiltration Modeling
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Goodrich, Jacqueline, The University of Queensland, Brisbane, Queensland, Australia
- Murugadass, Roshini P, The University of Queensland, Brisbane, Queensland, Australia
- White, Olivia, The University of Queensland, Brisbane, Queensland, Australia
- Goel, Deepshikha, The University of Queensland, Brisbane, Queensland, Australia
- Singh, Savita Devi, The University of Queensland, Brisbane, Queensland, Australia
- Minhas, Saleha, The University of Queensland, Brisbane, Queensland, Australia
- Alsaid, Jafar, Ochsner Medical Center, New Orleans, Louisiana, United States
Background
Hemodialysis (HD) is associated with hypoperfusion of the heart and the brain. Measuring peripheral blood pressure (BP) during HD is inefficient in detecting or preventing them. Central BP was proven to be associate with major cardiovascular events more than peripheral BP. Our objective was to measure the central BP during HD sessions and use it to dynamically adjust Na and ultrafiltration (UF) rate. Then compare systolic, diastolic, Pulse pressure, MAP and BP variability of these modified HD sessions with standard controlled sessions.
Methods
This was an open label prospective, interventional-controlled, single-center study started in April 2024 for 8 months. It included adult ESRD patients getting HD for more than 6 months admitted to our center. We excluded patients with decompensated heart failure, respiratory failure, hepatorenal syndrome, electrolyte abnormalities and stroke. The central BP measurements were recorded every 15 minutes during HD sessions via SphygmoCor XCEL. Dialysate sodium and UF rate were dynamically adjusted based on these readings. Central Systolic, diastolic, pulse pressure, MAP, and BP variation were compared with readings from consecutive controlled standard of care HD sessions for the same patients. Statistical analysis was performed using IBM SPSS version 21.
Results
A total of 18 patients were included. They had 65 HD sessions. Measurements of 1033 BP readings were recorded. 528 were central measurements performed during 33 modified HD sessions and 505 were peripheral measurements from 32 standard controlled HD sessions. Compared to the peripheral readings, the central BP readings had significant 17 mmHg lower systolic, 3 mmHg higher diastolic, 19 mmHg lower pulse pressures and 4 mmHg lower MAP.
BP variability during these sessions, with sodium and UF modification based on the central BP, were 33% less as compared to controlled sessions.
Conclusion
The central systolic BP, MAP, and pulse pressure were lower than the peripheral measurements. This difference during HD could result in undetectable target organ hypoperfusion.
Adjusting dialysate sodium concentrations and UF based on central BP led to reduced BP variation during the HD sessions.
Further studies are warranted to evaluate the impact on organ perfusion and cardiovascular outcomes.
Funding
- Private Foundation Support