以兩種資料探勘方式預測透析中低血壓事件:比較支持向量機法與羅吉斯迴歸法

Predict intradialytic hypotension with two data mining methods: comparison between support vector machines and logistic regression

蔡佩芬

羅吉斯迴歸法 ； 支持向量機法 ； 資料探勘 ； 血液透析 ； 低血壓 ； Logistic regression analysis ； Support vector machines ； Data mining ； Hypotension ； Hemodialysis

中臺科技大學健康產業管理研究所學位論文

2012年

碩士

陳永福

繁體中文

透析中低血壓 (IDH) 一直都是透析治療過程中棘手且嚴重的問題，臨床上也發展出許多方法介入以預防低血壓事件的發生，我們的研究目的主要是利用人工智慧分級設計一套模組來確立高危險透析患者。 數據來自於160位血液透析病患 (61位是易患低血壓病患 ; 另外99位則是對低血壓具耐受性的病患) ，採用支援向量機 (SVM) 以及羅吉斯回歸分析法 (LRA)。透析中低血壓的定義：低血壓發生時收縮壓<100mmHg 或者是症狀性的發生掉壓事件，（收縮壓掉壓幅度>20mmHg ，合併抽筋、頭暈、噁心、嘔吐、頭痛、冒冷汗、失去意識）， 以這兩種方法進行比較預測發生透析中低血壓的能力。 SVM整體分類的準確率 (81.3%) 優於LRA (76.3%)。另外在靈敏度和特異性部份， 兩者在SVM (70.5% & 87.9%) 的表現上亦是高於LRA (62.3% & 84.8%)。 SVM在用於預測透析中低血壓風險的表現上確實優於LRA。臨床決策支持系統設計與支持向量機的臨床應用可能有助於醫師鑑別透析治療的高危險患者。

Intradialytic hypotension (IDH) remains an important issue during hemodialysis treatment. Many tools were developed to investigate the mechanisms and predict the hypotensive events when receiving dialysis. Our aim is to design intelligent classifies to identify high risk hemodialysis patients. Data from 160 hemodialysis patients (61 IDH-prone, 99 IDH-resistant) were analyzed with support vector machines (SVM) and logistic regression analysis (LRA). The IDH event was defined as a systolic pressure <100mmHg or a fall in systolic pressure >20mmHg associated with symptoms of hypotension (cramps, dizziness, nausea, vomiting, headache, sweating, loss of consciousness). The different abilities to predict the occurrences of IDH were compared between these two methods. SVM demonstrated better overall classification accuracy (81.3%) compared to LRA (76.3%). It was also shown that SVM had higher sensitivity (70.5%) and specificity (87.9%) than LRA (sensitivity: 62.3% and specificity: 84.8%). SVM is superior to logistic regression method in predicting the risk of hypotension during hemodialysis. Clinical application of the clinical decision support system designed with SVM may be helpful for nephrologist in discriminating the high risk patients when receiving hemodialysis treatments.

1. Aronszajn, N. (1950). Theory of reproducing kernels. Transactions of the American mathematical society, 68, 337-404.
   連結：
2. Bigger, J. T., Jr., Fleiss, J. L., Steinman, R. C., Rolnitzky, L. M., Kleiger, R. E., & Rottman, J. N. (1992). Frequency domain measures of heart period variability and mortality after myocardial infarction. [Research Support, Non-U.S. Gov''tResearch Support, U.S. Gov''t, P.H.S.]. Circulation, 85(1), 164-171.
   連結：
3. Bleyer, A. J., Russell, G. B., & Satko, S. G. (1999). Sudden and cardiac death rates in hemodialysis patients. Kidney international, 55(4), 1553-1559.
   連結：
4. Block, G. A., Klassen, P. S., Lazarus, J. M., Ofsthun, N., Lowrie, E. G., & Chertow, G. M. (2004). Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. Journal of the American Society of Nephrology : JASN, 15(8), 2208-2218.
   連結：
5. Bonnemeier, H., Richardt, G., Potratz, J., Wiegand, U. K., Brandes, A., Kluge, N., et al. (2003). Circadian profile of cardiac autonomic nervous modulation in healthy subjects: differing effects of aging and gender on heart rate variability. [Clinical Trial]. Journal of cardiovascular electrophysiology, 14(8), 791-799.
   連結：
6. Cavalcanti, S., Severi, S., Chiari, L., Avanzolini, G., Enzmann, G., Bianco, G., et al. (1997). Autonomic nervous function during haemodialysis assessed by spectral analysis of heart-rate variability. [Comparative StudyResearch Support, Non-U.S. Gov''t]. Clinical science, 92(4), 351-359.
   連結：
7. Chakko, S., Mulingtapang, R. F., Huikuri, H. V., Kessler, K. M., Materson, B. J., & Myerburg, R. J. (1993). Alterations in heart rate variability and its circadian rhythm in hypertensive patients with left ventricular hypertrophy free of coronary artery disease. American heart journal, 126(6), 1364-1372.
   連結：
8. Chang, L. R., Lin, Y. H., Kuo, T. B., Wu Chang, H. C., Liu, C. M., Liu, C. C., et al. (2011). Autonomic modulation and health-related quality of life among schizophrenic patients treated with non-intensive case management. [Research Support, Non-U.S. Gov''t]. PloS one, 6(11), e26378.
   連結：
9. Chesterton, L. J., Selby, N. M., Burton, J. O., Fialova, J., Chan, C., & McIntyre, C. W. (2010). Categorization of the hemodynamic response to hemodialysis: the importance of baroreflex sensitivity. Hemodialysis international. International Symposium on Home Hemodialysis, 14(1), 18-28.
   連結：
10. Cripps, T. R., Malik, M., Farrell, T. G., & Camm, A. J. (1991). Prognostic value of reduced heart rate variability after myocardial infarction: clinical evaluation of a new analysis method. British heart journal, 65(1), 14-19.
    連結：
11. Dasselaar, J. J., van der Sande, F. M., & Franssen, C. F. (2012). Critical Evaluation of Blood Volume Measurements during Hemodialysis. Blood purification, 33(1-3), 177-182.
    連結：
12. Daugirdas, J. T. (1991). Dialysis hypotension: a hemodynamic analysis. [Editorial]. Kidney international, 39(2), 233-246.
    連結：
13. Dekker, J. M., Crow, R. S., Folsom, A. R., Hannan, P. J., Liao, D., Swenne, C. A., et al. (2000). Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. [Research Support, Non-U.S. Gov''t]. Circulation, 102(11), 1239-1244.
    連結：
14. Dheenan, S., & Henrich, W. L. (2001). Preventing dialysis hypotension: a comparison of usual protective maneuvers. [Clinical TrialComparative StudyRandomized Controlled Trial]. Kidney international, 59(3), 1175-1181.
    連結：
15. Dougherty, C. M., & Burr, R. L. (1992). Comparison of heart rate variability in survivors and nonsurvivors of sudden cardiac arrest. [Comparative StudyResearch Support, Non-U.S. Gov''tResearch Support, U.S. Gov''t, P.H.S.]. The American journal of cardiology, 70(4), 441-448.
    連結：
16. Fayyad, U. (1997). Knowledge discovery in databases: An overviewInductive Logic Programming. In N. Lavrac & S. Džeroski (Eds.), (Vol. 1297, pp. 1-16): Springer Berlin / Heidelberg.
    連結：
17. Foley, R. N., Parfrey, P. S., & Sarnak, M. J. (1998). Clinical epidemiology of cardiovascular disease in chronic renal disease. [Review]. American journal of kidney diseases : the official journal of the National Kidney Foundation, 32(5 Suppl 3), S112-119.
    連結：
18. Franssen, C. F. (2006). Adenosine and dialysis hypotension. [Comment]. Kidney international, 69(5), 789-791.
    連結：
19. Goodkin, D. A., Bragg-Gresham, J. L., Koenig, K. G., Wolfe, R. A., Akiba, T., Andreucci, V. E., et al. (2003). Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). [Comparative StudyResearch Support, Non-U.S. Gov''t]. Journal of the American Society of Nephrology : JASN, 14(12), 3270-3277.
    連結：
20. Hanss, R., Bein, B., Ledowski, T., Lehmkuhl, M., Ohnesorge, H., Scherkl, W., et al. (2005). Heart rate variability predicts severe hypotension after spinal anesthesia for elective cesarean delivery. [Comparative Study]. Anesthesiology, 102(6), 1086-1093.
    連結：
21. Harnett, J. D., Foley, R. N., Kent, G. M., Barre, P. E., Murray, D., & Parfrey, P. S. (1995). Congestive heart failure in dialysis patients: prevalence, incidence, prognosis and risk factors. [Clinical TrialMulticenter StudyResearch Support, Non-U.S. Gov''t]. Kidney international, 47(3), 884-890.
    連結：
22. Hekmat, R., Ahmadi, M., Fatehi, H., Dadpour, B., & Fazelenejad, A. (2011). Correlation between asymptomatic intradialytic hypotension and regional left ventricular dysfunction in hemodialysis patients. Iranian journal of kidney diseases, 5(2), 97-102.
    連結：
23. Held, P. J., Pauly, M. V., & Diamond, L. (1987). Survival analysis of patients undergoing dialysis. JAMA : the journal of the American Medical Association, 257(5), 645-650.
    連結：
24. Ino-Oka, E., Urae, J., Sekino, M., Satoh, M., Takeuchi, K., Sekino, H., et al. (2011). Blood pressure and sympathetic nerve tone relation during hemodialysis may reflect cardiovascular dysfunction. Internal medicine, 50(22), 2741-2748.
    連結：
25. Javed, F., Savkin, A. V., Chan, G. S., Mackie, J. D., & Lovell, N. H. (2012). Recent advances in the monitoring and control of haemodynamic variables during haemodialysis: a review. [Research Support, Non-U.S. Gov''t]. Physiological measurement, 33(1), R1-R31.
    連結：
26. Javed, F., Savkin, A. V., Chan, G. S., Middleton, P. M., Malouf, P., Steel, E., et al. (2010). Model predictive control of relative blood volume and heart rate during hemodialysis. Medical & biologicalengineering & computing, 48(4), 389-397.
    連結：
27. Javed, F., Savkin, A. V., Chan, G. S., Middleton, P. M., Malouf, P., Steel, E., et al. (2009). Assessing the blood volume and heart rate responses during haemodialysis in fluid overloaded patients using support vector regression. [Comparative StudyResearch Support, Non-U.S. Gov''t]. Physiological measurement, 30(11), 1251-1266.
    連結：
28. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. (2002). [GuidelinePractice Guideline]. American journal of kidney diseases : the official journal of the National Kidney Foundation, 39(2 Suppl 1), S1-266.
    連結：
29. Kazuya Yamamoto1, N. K., Toshiki Kutsuna1, Akira Ishii1, Takuya Matsumoto1, Miyako Hara1, Naoko Aiba1, Minoru Tabata1, Naonobu Takahira2, Takashi Masuda2,*. (2012). Excessive Fall of Blood Pressure During Maintenance Hemodialysis in Patients With Chronic Renal Failure is Induced by Vascular Malfunction and Imbalance of Autonomic Nervous Activity. Therapeutic Apheresis and Dialysis.
    連結：
30. Kleiger, R. E., Miller, J. P., Bigger, J. T., Jr., & Moss, A. J. (1987). Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. [Comparative StudyResearch Support, Non-U.S. Gov''tResearch Support, U.S. Gov''t, P.H.S.]. The American journal of cardiology, 59(4), 256-262.
    連結：
31. Kleiger, R. E., Stein, P. K., Bosner, M. S., & Rottman, J. N. (1992). Time domain measurements of heart rate variability. [Review]. Cardiology clinics, 10(3), 487-498.
    連結：
32. Kobayashi, H., Ishibashi, K., & Noguchi, H. (1999). Heart rate variability; an index for monitoring and analyzing human autonomic activities. [Review]. Applied human science : journal of physiological anthropology, 18(2), 53-59.
    連結：
33. Kuo, T. B., Lin, T., Yang, C. C., Li, C. L., Chen, C. F., & Chou, P. (1999). Effect of aging on gender differences in neural control of heart rate. [Research Support, Non-U.S. Gov''t]. The American journal of physiology, 277(6 Pt 2), H2233-2239.
    連結：
34. La Rovere, M. T., Pinna, G. D., Hohnloser, S. H., Marcus, F. I., Mortara, A., Nohara, R., et al. (2001). Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation, 103(16), 2072-2077.
    連結：
35. Lombardi, F., & Mortara, A. (1998). Heart rate variability and cardiac failure. [EditorialReview]. Heart, 80(3), 213-214.
    連結：
36. Lowrie, E. G., & Lew, N. L. (1990). Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. [Comparative Study]. American journal of kidney diseases : the official journal of the National Kidney Foundation, 15(5), 458-482.
    連結：
37. Malliani, A., Lombardi, F., & Pagani, M. (1994). Power spectrum analysis of heart rate variability: a tool to explore neural regulatory mechanisms. [Editorial]. British heart journal, 71(1), 1-2.
    連結：
38. Malliani, A., Pagani, M., Lombardi, F., & Cerutti, S. (1991). Cardiovascular neural regulation explored in the frequency domain. [Review]. Circulation, 84(2), 482-492.
    連結：
39. Malpas, S. C., & Maling, T. J. (1990). Heart-rate variability and cardiac autonomic function in diabetes. [Research Support, Non-U.S. Gov''t]. Diabetes, 39(10), 1177-1181.
    連結：
40. Meyhoff, C. S., Haarmark, C., Kanters, J. K., & Rasmussen, L. S. (2009). Is it possible to predict hypotension during onset of spinal anesthesia in elderly patients? [Clinical TrialResearch Support, Non-U.S. Gov''t]. Journal of clinical anesthesia, 21(1), 23-29.
    連結：
41. Nakamoto, H., Honda, N., Mimura, T., & Suzuki, H. (2006). Hypoalbuminemia is an important risk factor of hypotension during hemodialysis. Hemodialysis international. International Symposium on Home Hemodialysis, 10 Suppl 2, S10-15.
    連結：
42. Palmer, B. F., & Henrich, W. L. (2008). Recent advances in the prevention and management of intradialytic hypotension. Journal of the American Society of Nephrology : JASN, 19(1), 8-11.
    連結：
43. Perico, N., Codreanu, I., Schieppati, A., & Remuzzi, G. (2005). The future of renoprotection. Kidney international, 68(S97), S95-S101.
    連結：
44. Pifer, T. B., McCullough, K. P., Port, F. K., Goodkin, D. A., Maroni, B. J., Held, P. J., et al. (2002). Mortality risk in hemodialysis patients and changes in nutritional indicators: DOPPS. [Research Support, Non-U.S. Gov''t]. Kidney international, 62(6), 2238-2245.
    連結：
45. Ponikowski, P., Anker, S. D., Chua, T. P., Szelemej, R., Piepoli, M., Adamopoulos, S., et al. (1997). Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. The American journal of cardiology, 79(12), 1645-1650.
    連結：
46. Richard A. Sherman, J. T. D., and Todd S. Ing. (2007). Complications During Hemodialysis. Handbook of dialysis, 236, p170-191.
    連結：
47. Roche, F., Gaspoz, J. M., Court-Fortune, I., Minini, P., Pichot, V., Duverney, D., et al. (1999). Screening of obstructive sleep apnea syndrome by heart rate variability analysis. [Clinical TrialComparative Study]. Circulation, 100(13), 1411-1415.
    連結：
48. Rohde, L. E., Polanczyk, C. A., Moraes, R. S., Ferlin, E., & Ribeiro, J. P. (1998). Effect of partial arrhythmia suppression with amiodarone on heart rate variability of patients with congestive heart failure. [Comparative StudyResearch Support, Non-U.S. Gov''t]. American heart journal, 136(1), 31-36.
    連結：
49. Rostoker, G., Griuncelli, M., Loridon, C., Benmaadi, A., & Illouz, E. (2009). Left-ventricular diastolic dysfunction as a risk factor for dialytic hypotension. [Comparative StudyResearch Support, Non-U.S. Gov''t]. Cardiology, 114(2), 142-149.
    連結：
50. Rubinger, D., Sapoznikov, D., Pollak, A., Popovtzer, M. M., & Luria, M. H. (1999). Heart rate variability during chronic hemodialysis and after renal transplantation: studies in patients without and with systemic amyloidosis. Journal of the American Society of Nephrology : JASN, 10(9), 1972-1981.
    連結：
51. Salzberg, S. L. (1994). C4.5: Programs for Machine Learning by J. Ross Quinlan. Morgan Kaufmann Publishers, Inc., 1993. Machine Learning, 16(3), 235-240.
    連結：
52. Sapoznikov, D., Backenroth, R., & Rubinger, D. (2010). Baroreflex sensitivity and sympatho-vagal balance during intradialytic hypotensive episodes. Journal of hypertension, 28(2), 314-324.
    連結：
53. Satko, S. G., Freedman, B. I., & Moossavi, S. (2005). Genetic factors in end-stage renal disease. Kidney international, 67(S94), S46-S49.
    連結：
54. Sebastiani, F. (2002). Machine learning in automated text categorization. ACM Comput. Surv., 34(1), 1-47.
    連結：
55. Shoji, T., Tsubakihara, Y., Fujii, M., & Imai, E. (2004). Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. [Multicenter StudyResearch Support, Non-U.S. Gov''t]. Kidney international, 66(3), 1212-1220.
    連結：
56. Stein, P. K., Ehsani, A. A., Domitrovich, P. P., Kleiger, R. E., & Rottman, J. N. (1999). Effect of exercise training on heart rate variability in healthy older adults. [Research Support, U.S. Gov''t, P.H.S.]. American heart journal, 138(3 Pt 1), 567-576.
    連結：
57. Sulowicz, W., & Radziszewski, A. (2006). Pathogenesis and treatment of dialysis hypotension. Kidney international, 70(S104), S36-S39.
    連結：
58. Sztajzel, J. M., Vinolas, X., Sobral, J., Dumaresq, L., Boveda, S., Torner, P., et al. (1997). Heart Rate Variability Early After Successful Radiofrequency Catheter Ablation of Left- and Right-Sided Accessory Pathways and After Selective Ablation of the Slow Pathway. Annals of Noninvasive Electrocardiology, 2(4), 362-369.
    連結：
59. Vapnik, V. N. (2000). The nature of statistical learning theory. Springer.
    連結：
60. Verri, M. P. A. (1998). Support Vector Machines for 3D Object Reconition. IEEE Transaction On Pattern Analysis And Machine Intelligence, 20, 637-646.
    連結：
61. 台灣腎臟醫學會. (2010). 慢性腎臟病防治手冊. In 行政院衛生署國民健康局 (Eds.) (Vol. 第四章, pp. p9-12).
    連結：
62. Barth, C., Boer, W., Garzoni, D., Kuenzi, T., Ries, W., Schaefer, R., et al. (2003). Characteristics of hypotension-prone haemodialysis patients: is there a critical relative blood volume? [Evaluation StudiesMulticenter StudyResearch Support, Non-U.S. Gov''t]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 18(7), 1353-1360.
63. Basile, C., Giordano, R., Vernaglione, L., Montanaro, A., De Maio, P., De Padova, F., et al. (2001). Efficacy and safety of haemodialysis treatment with the Hemocontrol biofeedback system: a prospective medium-term study. [Clinical TrialComparative Study]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 16(2), 328-334.
64. BURGES, C. J. C. (1998). A Tutorial on Support Vector Machines for Pattern Recognition. Data Mining and Knowledge Discovery, 2, 121-167.
65. Burton, J. O., Jefferies, H. J., Selby, N. M., & McIntyre, C. W. (2009). Hemodialysis-induced cardiac injury: determinants and associated outcomes. [Research Support, Non-U.S. Gov''t]. Clinical journal of the American Society of Nephrology : CJASN, 4(5), 914-920.
66. Calvo, C., Maule, S., Mecca, F., Quadri, R., Martina, G., & Cavallo Perin, P. (2002). The influence of autonomic neuropathy on hypotension during hemodialysis. Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 12(2), 84-87.
67. Chan, C. T., Levin, N. W., Chertow, G. M., Larive, B., Schulman, G., & Kotanko, P. (2010). Determinants of cardiac autonomic dysfunction in ESRD. [Research Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov''t]. Clinical journal of the American Society of Nephrology : CJASN, 5(10), 1821-1827.
68. Cheung, A. K., Sarnak, M. J., Yan, G., Berkoben, M., Heyka, R., Kaufman, A., et al. (2004). Cardiac diseases in maintenance hemodialysis patients: results of the HEMO Study. [Clinical TrialMulticenter StudyRandomized Controlled Trial]. Kidney international, 65(6), 2380-2389.
69. Converse, R. L., Jr., Jacobsen, T. N., Jost, C. M., Toto, R. D., Grayburn, P. A., Obregon, T. M., et al. (1992). Paradoxical withdrawal of reflex vasoconstriction as a cause of hemodialysis-induced hypotension. [Research Support, Non-U.S. Gov''tResearch Support, U.S. Gov''t, P.H.S.]. The Journal of clinical investigation, 90(5), 1657-1665.
70. Davenport, A. (2006). Intradialytic complications during hemodialysis. [Comparative StudyReview]. Hemodialysis international. International Symposium on Home Hemodialysis, 10(2), 162-167.
71. Eckberg, D. L. (1997). Sympathovagal balance: a critical appraisal. [Research Support, U.S. Gov''t, Non-P.H.S.Research Support, U.S. Gov''t, P.H.S.Review]. Circulation, 96(9), 3224-3232.
72. Gabrielli, D., Krystal, B., Katzarski, K., Youssef, M., Hachache, T., Lopot, F., et al. (2009). Improved intradialytic stability during haemodialysis with blood volume-controlled ultrafiltration. [Comparative StudyMulticenter StudyRandomized Controlled TrialResearch Support, Non-U.S. Gov''t]. Journal of nephrology, 22(2), 232-240.
73. Gabutti, L., Bianchi, G., Soldini, D., Marone, C., & Burnier, M. (2009). Haemodynamic consequences of changing bicarbonate and calcium concentrations in haemodialysis fluids. [Randomized Controlled TrialResearch Support, Non-U.S. Gov''t]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 24(3), 973-981.
74. Gabutti, L., Ferrari, N., Giudici, G., Mombelli, G., & Marone, C. (2003). Unexpected haemodynamic instability associated with standard bicarbonate haemodialysis. [Clinical TrialRandomized Controlled TrialResearch Support, Non-U.S. Gov''t]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 18(11), 2369-2376.
75. Hayes, W., & Hothi, D. K. (2011). Intradialytic hypotension. [Review]. Pediatric nephrology, 26(6), 867-879.Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. (1996). [GuidelinePractice Guideline]. Circulation, 93(5), 1043-1065.
76. Hnatkova, K., Copie, X., Staunton, A., & Malik, M. (1995). Numeric processing of Lorenz plots of R-R intervals from long-term ECGs. Comparison with time-domain measures of heart rate variability for risk stratification after myocardial infarction. [Comparative StudyResearch Support, Non-U.S. Gov''t]. Journal of electrocardiology, 28 Suppl, 74-80.
77. Huang, H. (1996). Business Rule Extraction from Legacy Code. Paper presented at the Proceedings of the 20th Conference on Computer Software and Applications.
78. Jim Curtis, B. R., Byron Roshto. (2008). Principles of dialysis. p76-87.K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. (2005). [GuidelinePractice Guideline]. American journal of kidney diseases : the official journal of the National Kidney Foundation, 45(4 Suppl 3), S1-153.
79. Le Heuzey, J. Y., Piot, O., Copie, X., Lavergne, T., & Guize, L. (1997). [Auricular vulnerability: what information can be obtained from the study of auricular vulnerability? How to perform this study?]. [Review]. Annales de cardiologie et d''angeiologie, 46(10), 679-681.
80. Levin, N. W., Morris, A. T., Lavarias, V. A., Wang, Y., Glabman, M. B., Leung, J. P., et al. (1996). Effects of body core temperature reduction on haemodynamic stability and haemodialysis efficacy at constant ultrafiltration. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 11 Suppl 2, 31-34.
81. Lysaght, M. J. (2002). Maintenance dialysis population dynamics: current trends and long-term implications. Journal of the American Society of Nephrology : JASN, 13 Suppl 1, S37-40.
82. Moeller, S., Gioberge, S., & Brown, G. (2002). ESRD patients in 2001: global overview of patients, treatment modalities and development trends. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 17(12), 2071-2076.
83. Ori, Z., Monir, G., Weiss, J., Sayhouni, X., & Singer, D. H. (1992). Heart rate variability. Frequency domain analysis. [Research Support, Non-U.S. Gov''tReview]. Cardiology clinics, 10(3), 499-537.
84. Prakash, S., Garg, A. X., Heidenheim, A. P., & House, A. A. (2004). Midodrine appears to be safe and effective for dialysis-induced hypotension: a systematic review. [Review]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 19(10), 2553-2558.
85. Rayner, H. C., Pisoni, R. L., Bommer, J., Canaud, B., Hecking, E., Locatelli, F., et al. (2004). Mortality and hospitalization in haemodialysis patients in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). [Research Support, Non-U.S. Gov''t]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 19(1), 108-120.
86. Rho, M., Perazella, M. A., Parikh, C. R., Peixoto, A. J., & Brewster, U. C. (2008). Serum vasopressin response in patients with intradialytic hypotension: a pilot study. [Clinical TrialResearch Support, N.I.H., Extramural]. Clinical journal of the American Society of Nephrology : CJASN, 3(3), 729-735.
87. Rouby, J. J., Rottembourg, J., Durande, J. P., Basset, J. Y., & Legrain, M. (1978). Importance of the plasma refilling rate in the genesis of hypovolaemic hypotension during regular dialysis and controlled sequential ultrafiltration-haemodialysis. Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association, 15, 239-244.
88. Rubinger, D., Backenroth, R., & Sapoznikov, D. (2009). Restoration of baroreflex function in patients with end-stage renal disease after renal transplantation. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 24(4), 1305-1313.
89. Rubinger, D., Revis, N., Pollak, A., Luria, M. H., & Sapoznikov, D. (2004). Predictors of haemodynamic instability and heart rate variability during haemodialysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 19(8), 2053-2060.
90. Sadowski, R. H., Allred, E. N., & Jabs, K. (1993). Sodium modeling ameliorates intradialytic and interdialytic symptoms in young hemodialysis patients. [Clinical TrialResearch Support, U.S. Gov''t, P.H.S.]. Journal of the American Society of Nephrology : JASN, 4(5), 1192-1198.
91. Sato, M., Horigome, I., Chiba, S., Furuta, T., Miyazaki, M., Hotta, O., et al. (2001). Autonomic insufficiency as a factor contributing to dialysis-induced hypotension. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 16(8), 1657-1662.
92. Shastri, S., Tangri, N., Tighiouart, H., Beck, G. J., Vlagopoulos, P., Ornt, D., et al. (2012). Predictors of sudden cardiac death: a competing risk approach in the hemodialysis study. [Research Support, N.I.H., Extramural]. Clinical journal of the American Society of Nephrology : CJASN, 7(1), 123-130.
93. Snyder, S., & Pendergraph, B. (2005). Detection and evaluation of chronic kidney disease. [Comparative StudyReview]. American family physician, 72(9), 1723-1732.
94. Tsuji, H., Venditti, F. J., Jr., Manders, E. S., Evans, J. C., Larson, M. G., Feldman, C. L., et al. (1994). Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. [Research Support, Non-U.S. Gov''t]. Circulation, 90(2), 878-883.van der Sande, F. M., Kooman, J. P., & Leunissen, K. M. (2000). Intradialytic hypotension--new concepts on an old problem. [EditorialReview]. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 15(11), 1746-1748.
95. van Ravenswaaij-Arts, C. M., Kollee, L. A., Hopman, J. C., Stoelinga, G. B., & van Geijn, H. P. (1993). Heart rate variability. [Review]. Annals of internal medicine, 118(6), 436-447.
96. Zhou, Y. L., Liu, H. L., Duan, X. F., Yao, Y., Sun, Y., & Liu, Q. (2006). Impact of sodium and ultrafiltration profiling on haemodialysis-related hypotension. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 21(11), 3231-3237.
97. 行政院衛生署RSS新聞. (2010/4/30). 積極掌控造成糖尿病患腎病變危險因子有效降低台灣洗腎人口. (行政院衛生署).