Measuring Cardiovascular Stress in Patients on Hemodialysis Study II

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.