Clinical applications of biofeedback systems in hemodialysis

Abstract

Despite the tremendous progress in hemodialysis technology over the past decades, hemodynamic instability during hemodialysis is still a frequent complication. This is caused by the fact that in most patients large amounts of fluid are being removed over a short period of time, in combination with an increasingly higher proportion of (elderly) patients with significant cardiovascular co-morbidity. In recent years various closed-loop techniques have been developed to prevent hemodynamic instability during hemodialysis. These techniques differ with respect to the input and output parameters but have in common that they are based on current concepts of the pathophysiology of dialysis hypotension. In this chapter we will outline the pathophysiology of dialysis hypotension and discuss the various closed-loop techniques for hemodialysis that are currently available. © 2013 Springer-Verlag Berlin Heidelberg.