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- Title
Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients.
- Authors
Chou, Yu‐Hsiang; Huang, Wei‐Lieh; Chang, Chin‐Hao; Yang, Cheryl C. H.; Kuo, Terry B. J.; Lin, Shuei‐Liong; Chiang, Wen‐Chih; Chu, Tzong‐Shinn
- Abstract
Aim: Autonomic dysfunction contributes to cardiovascular morbidity/mortality and can be evaluated with heart rate variability (HRV). This study is to evaluate the prognostic significance of HRV on renal function in non‐dialysis chronic kidney disease (CKD) patients. Methods: We enrolled 326 non‐dialysis CKD patients in this prospective observational study. The median follow‐up period was 2.02 years. Five‐minutes of electrocardiography recordings obtained at enrolment were reprocessed to assess HRV. Five frequency‐domain measures and one time‐domain measures were obtained. Rapid CKD progression was defined as annual estimated glomerular filtration rate (eGFR) loss over 30% per year or eGFR decline rate over 3 mL/min per 1.73 m2 per year. The prevalence of abnormal HRV, associated factors of HRV and impact of HRV on the risk of CKD progression were analyzed. Results: The abnormality of HRV increased along with the severity of CKD. In patients with stage 5 CKD, the proportion of abnormal ln(low frequency power) (LF), ln(high frequency power) (HF), lnLF/HF were 69.5, 52.8 and 50%, respectively. Associated factors of HRV included advanced CKD, diabetes mellitus, serum albumin, severe proteinuria, Beck Anxiety Inventory score, erythropoietin use, renin‐angiotensin system inhibitors and heart failure. Multivariate logistic regression model analysis revealed lower lnLF/HF, hypertension and severe proteinuria were the risk factors of rapid CKD progression. Conclusion: The prevalence of autonomic dysfunction measured by HRV among each stage CKD patients is different. Most patients in advanced CKD stage have reduced values of HRV parameters. The estimation of lnLF/HF also provided prognostic information on CKD progression in addition to classical risk factors. SUMMARY AT A GLANCE: This Taiwanese single centre study (n = 326) examined heart rate variability (a relatively simple measure of autonomic activity) in people with non‐dialysis chronic kidney disease (CKD) and found that abnormalities in this parameter (specifically low proportion of low‐frequency to high‐frequency power, a measure of sympathovagal balance) is an independent predictor of glomerular filtration rate (GFR) decline.
- Subjects
HEART beat; CHRONICALLY ill; KIDNEY diseases; HEART failure; CHRONIC kidney failure; RENIN-angiotensin system; GLOMERULAR filtration rate
- Publication
Nephrology, 2019, Vol 24, Issue 8, p806
- ISSN
1320-5358
- Publication type
Article
- DOI
10.1111/nep.13514