- Heart rate variability (HRV), over and above classical risk factors, can help predict rapid progression of chronic kidney disease (CKD).
Why this matters
- Autonomic dysfunction is a common CKD morbidity; this study showed that prevalence measured by HRV is different with each stage.
- Estimation of ln(low-frequency [LF] power)/ln(high-frequency [HF] power)—InLF/HF—by ECG is noninvasive and easily performed.
- Prospective observational study evaluating the prognostic significance of HRV on renal function in 326 patients (mean age, 57.89±8.71 years) with nondialysis CKD, followed for a median of 2.02 years.
- 137 patients (42.0%) experienced rapid CKD progression.
- Funding: Mrs. Hsiu-Chin Lee Kidney Research Foundation; National Taiwan University Hospital.
- HRV abnormality increased with CKD severity; in stage 5 CKD, the proportion of patients with abnormal InLF, InHF, and InLF/HF was 66.7%, 47.2%, and 27.8%, respectively.
- CKD severity correlated negatively with InLF (β, –0.13; P=.04) and InHF (β, –0.13; P=.049).
- Univariate factors for HRV included advanced CKD, diabetes, serum albumin, severe proteinuria, Beck Anxiety Inventory score, erythropoietin use, renin-angiotensin system inhibitors, and heart failure.
- Multivariate analysis identified 3 factors for rapid CKD progression: lower InLF/HF (aOR=0.07; P<.0001 hypertension p=".014)," and severe proteinuria>
- Lack of ECG verification by traditional methods.