Key result
Intravenous glucose partially reverses hemodialysis-induced reductions in cardiovascular signal complexity.
Why the study?
The study aimed to evaluate the effect of hemodialysis and glucose infusion on the amplitude aware permutation entropy of hemodynamic variables in chronic kidney disease patients with and without type-2 diabetes mellitus.
Does intravenous glucose infusion improve amplitude aware permutation entropy of hemodynamic variables during hemodialysis in patients with chronic kidney disease?
Observational (n=31)
No
Does intravenous glucose infusion improve amplitude aware permutation entropy of hemodynamic variables during hemodialysis in patients with chronic kidney disease?
Intravenous glucose infusion during hemodialysis may partially reverse the hemodialysis-induced impairment of autonomic cardiovascular control, potentially offering a strategy to prevent intradialytic hypotension.
May support testing glucose to mitigate hemodialysis-related entropy loss; hypothesis-generating in this observational cohort, needing randomized confirmation.
Background: The quality of autonomic blood pressure (BP) control can be assessed by the entropy of serial BP data. The aim of this study was to evaluate the effect of hemodialysis (HD) and glucose infusion (GI) on amplitude aware permutation entropy (AAPE) of hemodynamic variables during HD in chronic kidney disease patients with and without type-2 diabetes mellitus (DM). Methods: Twenty-one patients without DM (NDO) and ten with DM were studied. Thirty minutes after the start of HD, a 40% glucose solution was administered. Hemodynamic data were extracted from continuous recordings using the Portapres® system. Results: AAPE decreased during HD in all patients and all hemodynamic signals with the exception of AAPE of mean and diastolic BP in DM patients. GI led to an increase in AAPE for cardiac output in all patients, while AAPE for heart rate and ejection time increased only in DM studies, and AAPE for systolic, diastolic, and mean arterial pressure, as well as total peripheral resistance, increased only in NDO patients. Conclusions: The reduction in entropy during HD indicates impaired autonomic control in response to external perturbations. This state is partially reversed by the infusion of glucose with differences in central and peripheral responsiveness in DM and NDO patients.
No takes yet. Share an insight, caveat, or question.
Niemczyk et al. (2022) conducted an observational in Chronic kidney disease on hemodialysis (n=31). Intravenous glucose infusion vs. Baseline/pre-infusion state during hemodialysis was evaluated on Amplitude aware permutation entropy (AAPE) of hemodynamic variables. Hemodialysis reduced the amplitude aware permutation entropy of cardiovascular signals, an effect that was partially reversed by intravenous glucose infusion with differing responses between diabetic and non-diabetic patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: