title: Heart rate variability and mortality in patients with end stage renal disease.
abstract: Heart rate variability (HRV), a measure of autonomic function, is associated with mortality in non-end stage renal disease (ESRD). The purpose of this pilot study was to determine if HRV was predictive of mortality in patients on dialysis and to identify at-risk factors. Patients on chronic hemodialysis (n = 53) were assessed at baseline and again 24 months later. Baseline measures quantified 24-hour HRV, health, depression, and quality of life (QoL). Twenty-four-month data determined mortality. Participants were African American, 49% male, aged 47.8+/-13.3 years, with 62.4+/-60 months of dialysis. Outcomes of 24-hour HRV measures were impaired for all groups. Factors including exercise and smoking were associated with diminished HRV. The low frequency-high frequency ratio was found to be the most influential HRV determinant of death. The ability to identify patients at-risk for death and to prescribe therapy to reduce risk could have significance for the care of patients with ESRD.
authors.affiliation: College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Ann K
authors.initials: AK
authors.lastname: Cashion
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Holmes
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
authors.forename: Sergio R
authors.initials: SR
authors.lastname: Acchiardo
authors.forename: Donna K
authors.initials: DK
authors.lastname: Hathaway
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D001007:Anxiety / Q000150:complications / Q000175:diagnosis; D003863:Depression / Q000150:complications / Q000175:diagnosis; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D005583:Fourier Analysis; D006339:Heart Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods* / Q000592:standards; D010865:Pilot Projects; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis