Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis.
Autonomic disturbance is common in end-stage kidney disease (ESKD). Heart rate variability (HRV) is a useful tool to assess autonomic function. We aimed to evaluate the predictive value of HRV on all-cause mortality and explore the proper timing of HRV assessment. This prospective cohort study enrol...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0282344 |
| _version_ | 1797848102082707456 |
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| author | Nichanan Osataphan Wanwarang Wongcharoen Arintaya Phrommintikul Phasakorn Putchagarn Kajohnsak Noppakun |
| author_facet | Nichanan Osataphan Wanwarang Wongcharoen Arintaya Phrommintikul Phasakorn Putchagarn Kajohnsak Noppakun |
| author_sort | Nichanan Osataphan |
| collection | DOAJ |
| description | Autonomic disturbance is common in end-stage kidney disease (ESKD). Heart rate variability (HRV) is a useful tool to assess autonomic function. We aimed to evaluate the predictive value of HRV on all-cause mortality and explore the proper timing of HRV assessment. This prospective cohort study enrolled 163 ESKD on hemodialysis patients from April-December 2018. HRV measurements were recorded ten minutes before hemodialysis, four hours during hemodialysis, and ten minutes after hemodialysis. Clinical parameters and all-cause mortality were recorded. Cox-proportional hazard regression was used for statistical analysis. After a median follow up of 40 months, 37 (22.7%) patients died. Post-dialysis HRV parameters including higher very low frequency (VLF) (hazard ratio [HR], 0.881; 95%confidence interval [CI], 0.828-0.937; p<0.001), higher normalized low frequency (nLF) (HR, 0.950; 95%CI, 0.917-0.984; p = 0.005) and higher LF/HF ratio (HR, 0.232; 95%CI, 0.087-0.619; p = 0.004) were the independent predictors associated with lower risk for all-cause mortality. Higher post-dialysis normalized high frequency (nHF) increased risk of mortality (HR, 1.051; 95%CI, 1.015-1.089; p = 0.005). HRV parameters at pre-dialysis and during dialysis were not predictive for all-cause mortality. The area under receiver operating characteristic curve (AuROC) of VLF for survival was highest compared to other HRV parameters at post-dialysis period (AuROC 0.71; 95% CI; 0.62-0.79; p<0.001). In conclusion, post-dialysis HRV parameters predicted all-cause mortaliy in ESKD. VLF measured at post-dialysis exhibited best predictive value for survival in chronic hemodialysis patients. |
| first_indexed | 2024-04-09T18:21:59Z |
| format | Article |
| id | doaj.art-545dd8f5cc10444a996693cb3752726b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T18:21:59Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-545dd8f5cc10444a996693cb3752726b2023-04-12T05:33:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e028234410.1371/journal.pone.0282344Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis.Nichanan OsataphanWanwarang WongcharoenArintaya PhrommintikulPhasakorn PutchagarnKajohnsak NoppakunAutonomic disturbance is common in end-stage kidney disease (ESKD). Heart rate variability (HRV) is a useful tool to assess autonomic function. We aimed to evaluate the predictive value of HRV on all-cause mortality and explore the proper timing of HRV assessment. This prospective cohort study enrolled 163 ESKD on hemodialysis patients from April-December 2018. HRV measurements were recorded ten minutes before hemodialysis, four hours during hemodialysis, and ten minutes after hemodialysis. Clinical parameters and all-cause mortality were recorded. Cox-proportional hazard regression was used for statistical analysis. After a median follow up of 40 months, 37 (22.7%) patients died. Post-dialysis HRV parameters including higher very low frequency (VLF) (hazard ratio [HR], 0.881; 95%confidence interval [CI], 0.828-0.937; p<0.001), higher normalized low frequency (nLF) (HR, 0.950; 95%CI, 0.917-0.984; p = 0.005) and higher LF/HF ratio (HR, 0.232; 95%CI, 0.087-0.619; p = 0.004) were the independent predictors associated with lower risk for all-cause mortality. Higher post-dialysis normalized high frequency (nHF) increased risk of mortality (HR, 1.051; 95%CI, 1.015-1.089; p = 0.005). HRV parameters at pre-dialysis and during dialysis were not predictive for all-cause mortality. The area under receiver operating characteristic curve (AuROC) of VLF for survival was highest compared to other HRV parameters at post-dialysis period (AuROC 0.71; 95% CI; 0.62-0.79; p<0.001). In conclusion, post-dialysis HRV parameters predicted all-cause mortaliy in ESKD. VLF measured at post-dialysis exhibited best predictive value for survival in chronic hemodialysis patients.https://doi.org/10.1371/journal.pone.0282344 |
| spellingShingle | Nichanan Osataphan Wanwarang Wongcharoen Arintaya Phrommintikul Phasakorn Putchagarn Kajohnsak Noppakun Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. PLoS ONE |
| title | Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. |
| title_full | Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. |
| title_fullStr | Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. |
| title_full_unstemmed | Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. |
| title_short | Predictive value of heart rate variability on long-term mortality in end-stage kidney disease on hemodialysis. |
| title_sort | predictive value of heart rate variability on long term mortality in end stage kidney disease on hemodialysis |
| url | https://doi.org/10.1371/journal.pone.0282344 |
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