A Comprehensive Approach for Mitigating Intradialytic Hypotension: Leveraging Enhanced Venous Return and Guided Respiratory Modulation in Patients with End-Stage Renal Disease

Abstract

Intradialytic hypotension (IDH) continues to be a significant and persistent hurdle for individuals with end-stage renal disease (ESRD) undergoing hemodialysis (HD), frequently undermining treatment consistency and diminishing overall patient well-being. Although lowering ultrafiltration rates is a conventional strategy to counteract IDH episodes, its reliance can constrain fluid removal efficacy in everyday clinical settings. To address this gap, we propose a novel framework, Smart External Pulsatile Compression (SEPC), which integrates sophisticated wearable biosensors, intermittent pneumatic compression (IPC) for peripheral venous return enhancement, and structured respiratory rhythm exercises aimed at promoting hemodynamic equilibrium. Early clinical observations reveal that SEPC not only attenuates the occurrence of hypotensive events but also sustains effective fluid extraction, indicating a potentially transformative solution for augmenting HD safety and patient comfort. By maintaining optimal ultrafiltration while curtailing IDH, SEPC offers a multidimensional modality poised to improve clinical outcomes, reinforce health-related quality of life, and serve as a valuable asset in the broader arena of medical and health informatics research.