Characterization of Cardiovascular Health for Chronic Dialysis Patients Using Continuous Non-Invasive Cardiac Output Monitoring

There were 485,000 end stage renal disease patients in the U.S. as of 2005 with 785,000 projected by 2020. Mortality while on chronic hemodialysis is very high reaching 65% at 5 years after starting hemodialysis [1]. The prevalence of cardiovascular disease and left ventricular hypertrophy in these patients is 40% and 75%, respectively [2]. Cardiovascular disease is the most common cause of death in dialysis patients accounting for over half of patient deaths. Most of this excess mortality is due to heart disease and consequently heart failure with its associated fluid retention. Thus, both fluid overload and heart failure commonly co-exist in patients on chronic hemodialysis [3]. Moreover, intradialytic hypotension (IDH) resulting from the excessive removal of fluid in patients at risk, primarily those with underlying cardiac disease (left ventricular hypertrophy or dysfunction, coronary artery disease), is an underappreciated problem which may contribute to the increased mortality of endstage renal disease (ESRD) patients through cardiac ischemia/ acute coronary syndrome, cardiac arrhythmias, vascular autoregulatory dysfunction, and endothelial abnormalities with increased thrombogenecity. Patients with frequent IDH have Abstract