Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients

Yu Hsiang Chou, Wei Lieh Huang, Chin Hao Chang, Cheryl C.H. Yang, Terry B.J. Kuo, Shuei Liong Lin, Wen Chih Chiang, Tzong Shinn Chu

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

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.

原文英語
頁(從 - 到)806-813
頁數8
期刊Nephrology
24
發行號8
DOIs
出版狀態已發佈 - 八月 1 2019
對外發佈Yes

指紋

Chronic Renal Insufficiency
Heart Rate
Kidney
Disease Progression
Glomerular Filtration Rate
Proteinuria
Logistic Models
Renin-Angiotensin System
Erythropoietin
Serum Albumin
Observational Studies
Diabetes Mellitus
Electrocardiography
Anxiety
Heart Failure
Regression Analysis
Power (Psychology)
Prospective Studies
Hypertension
Morbidity

ASJC Scopus subject areas

  • Nephrology

引用此文

Chou, Y. H., Huang, W. L., Chang, C. H., Yang, C. C. H., Kuo, T. B. J., Lin, S. L., ... Chu, T. S. (2019). Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients. Nephrology, 24(8), 806-813. https://doi.org/10.1111/nep.13514

Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients. / 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.

於: Nephrology, 卷 24, 編號 8, 01.08.2019, p. 806-813.

研究成果: 雜誌貢獻文章

Chou, YH, Huang, WL, Chang, CH, Yang, CCH, Kuo, TBJ, Lin, SL, Chiang, WC & Chu, TS 2019, 'Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients', Nephrology, 卷 24, 編號 8, 頁 806-813. https://doi.org/10.1111/nep.13514
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. / Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients. 於: Nephrology. 2019 ; 卷 24, 編號 8. 頁 806-813.
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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.",
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author = "Chou, {Yu Hsiang} and Huang, {Wei Lieh} and Chang, {Chin Hao} and Yang, {Cheryl C.H.} and Kuo, {Terry B.J.} and Lin, {Shuei Liong} and Chiang, {Wen Chih} and Chu, {Tzong Shinn}",
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AU - Chou, Yu Hsiang

AU - Huang, Wei Lieh

AU - Chang, Chin Hao

AU - Yang, Cheryl C.H.

AU - Kuo, Terry B.J.

AU - Lin, Shuei Liong

AU - Chiang, Wen Chih

AU - Chu, Tzong Shinn

PY - 2019/8/1

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N2 - 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.

AB - 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.

KW - autonomic dysfunction

KW - chronic kidney disease

KW - heart rate variability

KW - renal function progression

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