Parametric analysis of heart rate variability during hemodialysis

The problem of evaluating short-term autonomic response to hypovolemia in patients under chronic hemodialysis treatment is considered. Power spectra of the beat-to-beat heart rate variability were evaluated during the dialysis treatment in twenty hemodynamically stable and unstable patients, using a parametric technique. The autoregressive model coefficients were calculated by the modified covariance method, while model order was selected according to the minimum description length criterion. Reported results demonstrate that stable and unstable patients present markedly different spectral patterns. The efficiency of the compensatory response to hemodialysis-induced hypovolemia was evaluated through the ratio between the powers in LF and HF bands. Stable patients exhibit a LF/HF ratio greater than one with large fluctuations over the whole dialysis session. In contrast, all the unstable patients are characterized by a value of LF/HF lower than one and with a reduced time variability. This result suggests that the hemodynamic instability of the hypotension-prone patients may be due to a deficiency in the short-term compensatory response to the hemodialysis-induced hypovolemia.