Measuring Cardiovascular Stress in Patients on Hemodialysis Study II
Measuring Cardiovascular Stress in Patients on Hemodialysis Study II
The overall goal is to evaluate the predictive accuracy of a measure of autoregulatory
 adequacy derived from CVInsight and compare it with other measures in recognizing hypotensive
 events during hemodialysis..
Specific Aims are as follows:

 1. Assess the accuracy of a new rule set for CVInsight® in predicting intradialytic
 hypotensive episodes.

 2. Assess the comparative predictive accuracy of CVInsight® to other measures with regard
 to intradialytic hypotensive events.

 3. Assess estimated dry weight goals by monitoring post-dialytic vascular refill using
 CVInsight® and other measures.

 4. Assess hemodialysis(HD)-induced myocardial injury by monitoring the occurrence and
 frequency of arrhythmias and the levels of cardiac Troponin T.
Inclusion Criteria:

 Eligibility shall consist of the following:

 -  Age ≥ 20 years old

 -  Speaks and understands English, Spanish or Chinese

 -  Provides Informed Consent

 -  Patients with 20% intradialytic hypotensive events over the last two months.

 Exclusion criteria for both groups:

 -  Unstable hemodialysis patients per judgment of the clinician prior to the start of the
 treatment

 -  Patients unable to have blood pressure cuff measured on the upper arm

 -  Inability to wear monitor on forehead

 -  Patients treated with sodium or ultrafiltration profiling and the patient's
 nephrologist is unwilling to alter this for the study treatments

 -  Patients unwilling to shave the anterior chest

 -  Patients with active infection of the upper chest wall tissue.

 -  Patients with a deep brain stimulator, as it may disrupt the quality of the ECG data.

 -  Patients who are unwilling to take short showers versus bathing during the 7 day
 period .

 -  Patients who require intradialytic testing (ie transonic) during the monitored
 treatment.