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dc.contributor.authorZanotto, Tobia; orcid: 0000-0002-6571-4763
dc.contributor.authorMercer, Thomas H
dc.contributor.authorvan der Linden, Marietta L
dc.contributor.authorTraynor, Jamie P
dc.contributor.authorPetrie, Colin J
dc.contributor.authorDoyle, Arthur
dc.contributor.authorChalmers, Karen
dc.contributor.authorAllan, Nicola
dc.contributor.authorPrice, Jonathan
dc.contributor.authorOun, Hadi
dc.contributor.authorShilliday, Ilona
dc.contributor.authorKoufaki, Pelagia
dc.date.accessioned2019-01-08T01:22:58Z
dc.date.available2019-01-08T01:22:58Z
dc.date.issued2018-12-06
dc.identifierpmcid: PMC6283578
dc.identifierdoi: 10.1371/journal.pone.0208127
dc.identifierpmid: 30521545
dc.identifier.citationPloS one, volume 13, issue 12, page e0208127
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/9164
dc.descriptionFrom Europe PMC via Jisc Publications Router.
dc.descriptionPublication status: Published
dc.description.abstractBACKGROUND:Stage 5 chronic kidney disease patients on haemodialysis (HD) often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease. The dysregulation of blood pressure (BP) during orthostasis may be implicated in the aetiology of falls in these patients. Therefore, we explored the relationship between baroreflex function, the haemodynamic responses to a passive orthostatic challenge, and falls in HD patients. METHODS:Seventy-six HD patients were enrolled in this cross-sectional study. Participants were classified as "fallers" and "non-fallers" and completed a passive head up tilting to 60o (HUT-60°) test on an automated tilt table. ECG signals, continuous and oscillometric BP measurements and impedance cardiography were recorded. The following variables were derived from these measurements: heart rate (HR) stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR), number of baroreceptor events, and baroreceptor effectiveness index (BEI). RESULTS:The forty-four participants who were classified as fallers (57.9%) had a lower number of baroreceptor events (6.5±8.5 vs 14±16.7, p = .027) and BEI (20.8±24.2% vs 33.4±23.3%, p = .025). In addition, fallers experienced a significantly larger drop in systolic (-6.4±10.9 vs -0.4±7.7 mmHg, p = .011) and diastolic (-2.7±7.3 vs 1.8±6 mmHg, p = .027) oscillometric BP from supine to HUT-60° compared with non-fallers. None of the variables taken for the analysis were significantly associated with falls in multivariate logistic regression analysis. CONCLUSIONS:This cross-sectional comparison indicates that, at rest, HD patients with a positive history of falls present with a lower count of baroreceptor sequences and BEI. Short-term BP regulation warrants further investigation as BP drops during a passive orthostatic challenge may be implicated in the aetiology of falls in HD.
dc.languageeng
dc.rightsLicense cc by cc by
dc.sourceissn: 1932-6203
dc.sourcenlmid: 101285081
dc.sourceessn: 1932-6203
dc.titleBaroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients.
dc.typearticle
dc.date.updated2019-01-08T01:22:57Z


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