Non-invasive hemodynamic profiling of patients undergoing hemodialysis - a multicenter observational cohort study.

BACKGROUND: Intradialytic blood pressure (BP) measurement is currently the main parameter used for monitoring hemodynamics during hemodialysis (HD). Since BP is dependent on cardiac output and total peripheral resistance, knowledge of these parameters throughout the HD treatment would potentially be valuable. METHODS: The use of a novel non-invasive monitoring system for profiling hemodynamic response patterns during HD was explored: a whole-body bio-impedance system was used to assess cardiac index (CI), total peripheral resistance index (TPRI), cardiac power index (CPI) among other parameters in chronic HD patients from 4 medical centers. Measurements were made pre, during and post dialysis. Patients were grouped into 5 hemodynamic profiles based on their main hemodynamic response during dialysis i.e. high TPRI; high CPI; low CPI; low TPRI and those with normal hemodynamics. Comparisons were made between the groups for baseline characteristics and 1-year mortality. RESULTS: In 144 patients with mean age of 67.3 ± 12.1 years pre-dialysis hemodynamic measurements were within normal limits in 35.4% but only 6.9% overall remained hemodynamically stable during dialysis. Intradialytic BP decreased in 65 (45.1%) in whom, low CPI (47 (72.3%)) and low TPRI (18 (27.7%) were recorded. At 1-year follow-up, mortality rates were highest in patients with low CPI (23.4%) and low TPRI (22.2%). CONCLUSIONS: Non-invasive assessment of patients' response to HD provides relevant hemodynamic information that exceeds that provided by currently used BP measurements. Use of these online analyses could potentially improve the safety and performance standards of dialysis by guiding appropriate interventions, particularly in responding to hypertension and hypotension.

Cluster analysis based on serum iron and red blood cell and its significance in guiding diet nursing for patients with Alzheimer′s disease / 中国实用护理杂志

Objective To study on the difference of serum iron(Fe) levels between normal healthy people and patients with AD in order to explore the effect of serum iron level on the phenotypical division of AD patients and discuss its influence and significance in the diet nursing of AD patients. Methods A total of 30 patients with AD in Guangzhou Huiai Hospital were selected as the "AD group" from June 2014 to August 2017, and 30 healthy people in the corresponding health center of Guangzhou Huiai Hospital were selected as "the health control group". Data of general information, serum iron and red blood cell (RBC) index were collected in these two groups. General statistical analysis and cluster analysis were made based on the data. Results RBC in healthy control group and AD group were 4.60(4.38,5.00)×1012/L and (4.32±0.51)×1012/L. Compared with the healthy control group, RBC in the AD group was lower and the difference was statistically significant (Z=2.493,P＜0.05). But, the other indexes were not significantly different (P＞0.05). There was no significant difference in the in Fe level, RBC, hemoglobin and other indexes in AD patients with the different severity of dementia (P＞0.05). Based on the level of Fe and RBC, the 60 cases can be divided into four types of different characteristics.The Fe of four types were(12.39±2.35)(, 13.55±2.07),[20.70(19.55,23.15)], [19.70(17.70,22.60)] μmol/L, the RBC were (4.07±0.30), [4.83(4.62,5.12)], [4.40(4.14,4.45)], [5.00(4.80,5.34)] × 1012/L. The HGB were (125.30 ± 8.74),(138.08±11.1), [136.00(127.00,139.00)], (151.91±13.49)g/L.The incidence of four types of AD, Fe level,RBC and hemoglobin content were different (t/Z/χ2=0.019-6.942, P＜0.05). Conclusions Based on Fe and RBC, the population can be divided into 4 types. "Low Fe and low RBC"Type, "High Fe and high RBC"Type, "Low Fe and high RBC"Type and"High Fe and low RBC"."Low Fe and low RBC"Type contains most AD patients while "High Fe and high RBC"Type contains the least. There are close in the distribution of objects between"Low Fe and high RBC" and "High Fe and low RBC". According to the characteristics of these four types, different dietary care programs may be required

Cluster analysis based on serum iron and red blood cell and its significance in guiding diet nursing for patients with Alzheimer′s disease / 中国实用护理杂志

Objective@#To study on the difference of serum iron(Fe) levels between normal healthy people and patients with AD in order to explore the effect of serum iron level on the phenotypical division of AD patients and discuss its influence and significance in the diet nursing of AD patients.@*Methods@#A total of 30 patients with AD in Guangzhou Huiai Hospital were selected as the "AD group" from June 2014 to August 2017, and 30 healthy people in the corresponding health center of Guangzhou Huiai Hospital were selected as "the health control group". Data of general information, serum iron and red blood cell(RBC) index were collected in these two groups. General statistical analysis and cluster analysis were made based on the data.@*Results@#RBC in healthy control group and AD group were 4.60(4.38,5.00)×1012/L and (4.32±0.51)×1012/L. Compared with the healthy control group, RBC in the AD group was lower and the difference was statistically significant (Z=2.493, P<0.05). But, the other indexes were not significantly different (P>0.05). There was no significant difference in the in Fe level, RBC, hemoglobin and other indexes in AD patients with the different severity of dementia (P>0.05). Based on the level of Fe and RBC, the 60 cases can be divided into four types of different characteristics.The Fe of four types were (12.39±2.35) , (13.55±2.07) ,[20.70(19.55,23.15)], [19.70(17.70,22.60)] μmol/L, the RBC were (4.07±0.30), [4.83(4.62,5.12)], [4.40(4.14,4.45)], [5.00(4.80,5.34)]×1012/L. The HGB were (125.30±8.74), (138.08±11.1), [136.00(127.00,139.00)], (151.91±13.49)g/L.The incidence of four types of AD, Fe level, RBC and hemoglobin content were different (t/Z/χ2=0.019-6.942, P<0.05).@*Conclusions@#Based on Fe and RBC, the population can be divided into 4 types. "Low Fe and low RBC"Type, "High Fe and high RBC"Type, "Low Fe and high RBC"Type and"High Fe and low RBC"."Low Fe and low RBC"Type contains most AD patients while "High Fe and high RBC"Type contains the least. There are close in the distribution of objects between"Low Fe and high RBC" and "High Fe and low RBC". According to the characteristics of these four types, different dietary care programs may be required