scholarly journals Impaired heart rate variability in patients with non-diabetic chronic kidney disease — Prominent disruption of vagal control and daily fluctuation

2015 ◽  
Vol 9 ◽  
pp. 22-27 ◽  
Author(s):  
Hisaki Makimoto ◽  
Katsuhito Fujiu ◽  
Kohei Shimizu ◽  
Tina Lin ◽  
Eisuke Amiya ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2453
Author(s):  
Ana M Pinto ◽  
Helen L MacLaughlin ◽  
Wendy L Hall

Low heart rate variability (HRV) is independently associated with increased risk of sudden cardiac death (SCD) and all cardiac death in haemodialysis patients. Long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) may exert anti-arrhythmic effects. This study aimed to investigate relationships between dialysis, sleep and 24 h HRV and LC n-3 PUFA status in patients who have recently commenced haemodialysis. A cross-sectional study was conducted in adults aged 40–80 with chronic kidney disease (CKD) stage 5 (n = 45, mean age 58, SD 9, 20 females and 25 males, 39% with type 2 diabetes). Pre-dialysis blood samples were taken to measure erythrocyte and plasma fatty acid composition (wt % fatty acids). Mean erythrocyte omega-3 index was not associated with HRV following adjustment for age, BMI and use of β-blocker medication. Higher ratios of erythrocyte eicosapentaenoic acid (EPA) to docosahexaenoic acid (DHA) were associated with lower 24 h vagally-mediated beat-to-beat HRV parameters. Higher plasma EPA and docosapentaenoic acid (DPAn-3) were also associated with lower sleep-time and 24 h beat-to-beat variability. In contrast, higher plasma EPA was significantly related to higher overall and longer phase components of 24 h HRV. Further investigation is required to investigate whether patients commencing haemodialysis may have compromised conversion of EPA to DHA, which may impair vagally-mediated regulation of cardiac autonomic function, increasing risk of SCD.





2018 ◽  
Vol 50 (12) ◽  
pp. 2279-2288
Author(s):  
Huimin Chen ◽  
Ying Cui ◽  
Changying Xing ◽  
Yogendranath Purrunsing ◽  
Xiaoming Zha ◽  
...  


Nephrology ◽  
2019 ◽  
Vol 24 (8) ◽  
pp. 806-813 ◽  
Author(s):  
Yu‐Hsiang Chou ◽  
Wei‐Lieh Huang ◽  
Chin‐Hao Chang ◽  
Cheryl C. H. Yang ◽  
Terry B. J. Kuo ◽  
...  


Renal Failure ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 890-899
Author(s):  
Huimin Chen ◽  
Wenkai Ren ◽  
Zhanhui Gao ◽  
Ming Zeng ◽  
Shaowen Tang ◽  
...  




2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Jamie Michael O'Driscoll ◽  
Adrian Slee ◽  
Rajan Sharma

Background: Chronic kidney disease (CKD) is a silent clinical condition associated with adverse comorbidity and high cardiovascular disease (CVD) risk. An inverse relationship with body mass index (BMI) and mortality has been demonstrated in hemodialysis patients. However, it is unclear if this risk-factor paradox is evident in non-dialysis CKD patients. The aims of this study were to explore the relationship between, nutritional status, markers of inflammation, autonomic and cardiac function with BMI. Longitudinal follow-up explored the relationship between BMI and all-cause mortality. Methods: 211-consecutive CKD patients referred for dobutamine stress echocardiography to detect or exclude myocardial ischemia were recruited. BMI, albumin, C-reactive protein (CRP) and haemoglobin (Hb) were recorded as markers of nutritional and inflammatory status. Left ventricular ejection fraction (LVEF) and heart rate variability (HRV) as an indicator of cardiac function was recorded. All subjects were followed prospectively until November 2014 and study end-point was all-cause mortality. Results: BMI was inversely associated with CKD status. After covariate adjustment, this association remained. During a mean follow-up period of 3.3±0.9 years there were 35 deaths (17%). BMI was inversely associated with all-cause mortality (HR 0.81, 95% CI 0.71-0.9). Other important independent predictors of mortality were heart rate variability (HR 0.98, 95% CI 0.97-0.99), myocardial ischemia (HR 1.37, 95% CI 1.17-1.81), and albumin (HR 0.86, 95% CI 0.81-0.92). Conclusions: The presence of a body mass index paradox exists in non-dialysis CKD patients. This risk-factor paradox was an independent predictor of all-cause mortality and may have significant clinical implications relevant to screening, assessment and treatment and requires further study.



2018 ◽  
Vol 50 (11) ◽  
pp. 2061-2066 ◽  
Author(s):  
Yu Bao ◽  
Yi-An Wang ◽  
Hua Xiao ◽  
Ying Wang ◽  
Yan Wu ◽  
...  


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