Study of the autonomic response in hemodialysis patients with different fluid overload levels

This work aims at studying the autonomic nervous system (ANS) response to hemodialysis (HD) treatment in a population of end stage renal disease (ESRD) patients. ECG Holter recordings and whole body bioimpedance spectroscopy measurements were performed for each patient. Patients were classified according to the fluid overload (FO) values and the systolic blood pressure (SBP) measured before HD. Time domain and frequency domain indices from heart rate variability (HRV) signals were measured for the first 30 minutes and last 30 minutes of HD, the first hour after HD, and night (12.00 p.m.-4 a.m.). Significant differences were obtained in fluid overloaded but normotensive patients (Group IV) with respect to fluid overloaded and hypertensive patients (Group I) and normohydrated and normotensive patients (Group N+Dx). In particular, SDNN, RMSSD, SDSD, pNN50%, indices resulted significantly higher in Group IV with respect to the other groups. Overhydrated patients with hypertension (Group I) showed a blunted parasympathetic activity, which is supposed to contribute to hypertension.