Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Hemodialysis Efficiency Predictor in End Stage Kidney Disease Using Real-Time Heart Rate Variability

Sung Il Im
ORCID logo ,
Ye Na Kim
ORCID logo ,
Hyun Su Kim
,
Soo Jin Kim
,
Su Hyun Bae
,
Bong Joon Kim
,
Jung Ho Heo
,
YeonSoon Jung
,
Hark Rim
,
Sung Pil Cho
ORCID logo ,
Jung Hwan Park
,
Ho Sik Shin
* ORCID logo
Version 1 : Received: 15 January 2024 / Approved: 16 January 2024 / Online: 16 January 2024 (13:55:36 CET)

A peer-reviewed article of this Preprint also exists.

Im, S.I.; Kim, Y.N.; Kim, H.S.; Kim, S.J.; Bae, S.H.; Kim, B.J.; Heo, J.H.; Jung, Y.; Rim, H.; Cho, S.P.; Park, J.H.; Shin, H.S. Hemodialysis Efficiency Predictor in End-Stage Kidney Disease Using Real-Time Heart Rate Variability. Biomedicines 2024, 12, 474. Im, S.I.; Kim, Y.N.; Kim, H.S.; Kim, S.J.; Bae, S.H.; Kim, B.J.; Heo, J.H.; Jung, Y.; Rim, H.; Cho, S.P.; Park, J.H.; Shin, H.S. Hemodialysis Efficiency Predictor in End-Stage Kidney Disease Using Real-Time Heart Rate Variability. Biomedicines 2024, 12, 474.

Abstract

Background: Autonomic neuropathy commonly arises as a long-term complication in end stage kidney disease (ESKD) and can be diagnosed from heart rate variability (HRV), calculated from electrocardiogram (ECG) recordings. There is limited data about HRV using real-time ECG to predict HD efficiency in patients with ESKD who are routinely doing HD in real-world practice. Methods: Total of 50 patients (62.1 ± 10.7 years) with ESKD underwent continuous real-time ECG monitor (237.4 ± 15.3 min) during HD for HRV using remote monitoring system and checked electrolyte levels before/after HD. And we compared HRV according to electrolyte levels. Results: During the monitor, we checked total 2374 times of ECG and electrolyte level simultaneously of all patients. Both time and frequency domain HRV were higher when the patients had lower K+ level (<0.5 mEq/L) and P+ level change (<2 mEq/L) before/after HD as compared with those with higher K+ level (≥0.5 mEq/L) and P+ level (≥2 mEq/L) change respectively. In addition, there were higher incidence of arrhythmic events including atrial/ventricular premature complexes, even though no difference of mean heart rate in patients with lower K+ and P+ level change group (p < 0.001). Conclusions: Higher HRV was independently associated with poor controlled K+ and P+ level during hemodialysis in patients with ESKD. This is further substantiated by independent continuous associations between real-time measures of higher HRV and K+ and P+ level. These data strongly suggest that cardiac autonomic dysfunction can be caused by lower change of electrolytes before/after hemodialysis alone.

Keywords

predictors of hemodialysis; heart rate variability

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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