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- Title
Heart rate variability is an indicator for intradialytic hypotension among chronic hemodialysis patients.
- Authors
Chang, Yu-Ming; Shiao, Chih-Chung; Chang, Kuo-Chi; Chen, I-Ling; Yang, Chuan-Lan; Leu, Show-Chin; Su, Hung-Li; Kao, Jsun-Liang; Tsai, Shih-Ching; Jhen, Rong-Na
- Abstract
Background: Intradialytic hypotension (IDH) carries adverse impact. Heart rate variability (HRV) represents autonomic cardiac regulation which influences intradialytic blood pressure. We aimed to evaluate the association between IDH and HRV. Methods: This prospective study was carried out in a teaching hospital in Taiwan from June to August 2010. Adult patients on chronic hemodialysis without active medical conditions were enrolled and received HRV measurements for 4 times (before and during an index hemodialysis session). Patients were categorized by the changes of systolic blood pressure during the index hemodialysis into Group 1 (elevation >20 mmHg), Group 2 (decrease >20 mmHg), and Group 3 (others). Then we compared HRV indices among the three groups, and determined the indicators for IDH. Results: One hundred and seventy-one patients (96 women, mean age 64.9 years) were enrolled and categorized into Group 1 ( n = 47, 27.5 %), Group 2 ( n = 45, 26.3 %) and Group 3 ( n = 79, 46.2 %). Comparing with Group 1 and/or Group 3, Group 2 had significantly higher blood pressure at hemodialysis initiation (most p < 0.001) and statistically lower levels of HRV indices including variance, total power, very low-frequency, low-frequency and high-frequency since the middle phase of the hemodialysis. By logistic regression method, higher systemic blood pressure [odds ratio (OR) 1.048; p < 0.001], heart rate (OR 1.093; p = 0.021), low-frequency/high-frequency ratio (OR 1.715; p = 0.022), as well as lower variance (OR 0.639; p = 0.048) at hemodialysis initiation were independently associated with intradialytic blood pressure changes. Conclusions: HRV is a useful indicator for IDH among hemodialysis patients.
- Subjects
HEART rate monitoring; HYPOTENSION; HEMODIALYSIS patients; BLOOD pressure; HEMODIALYSIS
- Publication
Clinical & Experimental Nephrology, 2016, Vol 20, Issue 4, p650
- ISSN
1342-1751
- Publication type
Article
- DOI
10.1007/s10157-015-1189-9