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Predictors of heart rate variability and its prognostic significance in chronic kidney disease.
- Source :
-
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2012 Feb; Vol. 27 (2), pp. 700-9. Date of Electronic Publication: 2011 Sep 12. - Publication Year :
- 2012
-
Abstract
- Background: Heart rate variability (HRV), a noninvasive measure of autonomic dysfunction and a risk factor for cardiovascular disease (CVD), has not been systematically studied in nondialysis chronic kidney disease (CKD).<br />Methods: HRV was assessed using 24-h Holter monitoring in 305 subjects from the Renal Research Institute-CKD Study, a four-center prospective cohort of CKD (Stages 3-5). Multiple linear regression was used to assess predictors of HRV (both time and frequency domain) and Cox regression used to predict outcomes of CVD, composite of CVD/death and end-stage renal disease (ESRD).<br />Results: A total of 47 CVD, 67 ESRD and 24 death events occurred over a median follow-up of 2.7 years. Lower HRV was significantly associated with older age, female gender, diabetes, higher heart rate, C-reactive protein and phosphorus, lower serum albumin and Stage 5 CKD. Lower HRV (mostly frequency domain) was significantly associated with higher risk of CVD and the composite end point of CVD or death. Significantly, lower HRV (frequency domain) was associated with higher risk of progression to ESRD, although this effect was relatively weaker.<br />Conclusions: This study draws attention to the importance of HRV as a relatively under recognized predictor of adverse cardiovascular and renal outcomes in patients with nondialysis CKD. Whether interventions that improve HRV will improve these outcomes in this high-risk population deserves further study.
- Subjects :
- Age Distribution
Aged
Arrhythmias, Cardiac therapy
Cardiovascular Diseases diagnosis
Cardiovascular Diseases epidemiology
Cardiovascular Diseases therapy
Cohort Studies
Comorbidity
Disease Progression
Electrocardiography, Ambulatory
Female
Humans
Incidence
Kidney Failure, Chronic diagnosis
Kidney Failure, Chronic epidemiology
Kidney Failure, Chronic therapy
Linear Models
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Renal Dialysis
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic therapy
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Distribution
Survival Analysis
Arrhythmias, Cardiac diagnosis
Arrhythmias, Cardiac epidemiology
Cause of Death
Renal Insufficiency, Chronic epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2385
- Volume :
- 27
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Publication Type :
- Academic Journal
- Accession number :
- 21765187
- Full Text :
- https://doi.org/10.1093/ndt/gfr340