Sequential stockings12/16/2023 ![]() ![]() Furthermore, IDH has been associated with other medical complications such as vascular access thrombosis, and mesenteric ischemia. Clinically, IDH often leads to premature cessation of dialysis sessions, or decreased fluid removal, both of which not only decrease dialysis efficiency and effect, but also leads to decreased quality of life. Intra-dialytic hypotension is one of the most common complication of HD treatment, occurring in approximately 20–30% of HD sessions. Over time, such repeated injury can lead to ventricular remodeling that may further contribute to hemodynamic instability and dysregulation. For instance, previous investigations have found evidence of reduction in myocardial blood flow during dialysis, resulting in ischemia and myocardial stunning. In addition to the traditional cardiovascular risk factors, intra-dialytic hypotension (IDH) may be a key contributor to myocardial injury, and repeated injury during routine dialysis further precipitate progression of cardiovascular deterioration. There are disproportinaltely higher rates of heart failure and cardiac arrhythmia in this population and cardiovascular disease remains the leading cause of mortaliy. It is well recognized that patients with end stage renal disease (ESRD) requiring intermittent hemodialysis (HD) suffer excess cardiac morbidity and mortality. Trial registrationĬ, Identifier: NCT02915627, Registration Date: Sept 27, 2016. However, significant variations in hemodynamic outcomes exist, and may be a barrier for larger scale trials without prior identification of specific patient characteristics indicating likely benefit from the application of external compression. ![]() ConclusionsĪpplication of compression stockings to patients with renal dysfunction is well-tolerated. Some individuals saw large improvements in hemodynamic parameters while in others the opposite effect was observed. Hemodynamic response to lower body compression caused varying effects on cardiac output, mean arterial pressure and global longitudinal strain. ResultsĪll study participants tolerated the compression garments well and without complication. These outcome measurements were made before and after the application of compression stockings. Changes in global longitudinal strain were measured via echocardiography. Outcomes including hemodynamic parameters such as cardiac output, peripheral vascular resistance, and blood pressure were measured using continuous pulse wave analysis. Methodsįifteen individuals were enrolled in the study (5 healthy, 5 chronic kidney disease patients, and 5 dialysis patients). We also assessed the changes in hemodynamic measurements following the application of the compression stockings to explore the biological feasibility of this being an effective intervention for intradialytic hypotension. ![]() Therefore, we conducted this pilot study assessing the feasibility and tolerability of the application of non-pneumatic compression stockings to patients with kidney disease. Administration of non-pneumatic compression stockings to the lower limbs has demonstrated hemodynamic stabilizing effects in other settings and may provide similar benefits in the kidney disease population. Chronic exposure to intermittent hemodialysis may be a source of added stress to the cardiovascular system intradialytic hypotension is a common complication of hemodialysis, and repeated events may lead to hemodynamic stress and ischemic injuries. Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. ![]()
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