title: Autonomic function is associated with health-related quality of life in patients with end-stage renal disease: a case-control study.
abstract: OBJECTIVE
  In the present study, we assessed the associations among fatigue, quality of life (QOL), clinical parameters, and body mass index (BMI) with autonomic function in end-stage renal disease (ESRD) patients undergoing hemodialysis as well as fatigue-free healthy subjects.
  
  
  METHODS
  This was a case-control study. This study compared autonomic function in ESRD patients (n = 192) to that of healthy subjects (n = 282) and evaluated its association with fatigue, QOL, and clinical parameters such as glucose, albumin, cholesterol, and BMI. Fatigue was evaluated by a recently established fatigue questionnaire and performance status, and QOL was evaluated with the kidney disease QOL questionnaire. With regards to autonomic function, spontaneous beat-to-beat variations were measured, according to time- (standard deviation of all normal a-wave intervals [CVa-a%]) and frequency domains (low frequency [LF] power, high frequency [HF] power, and LF/HF ratio) with acceleration plethysmography.
  
  
  RESULTS
  CVa-a%, LF power, HF power, and LF/HF ratio were significantly lower in ESRD patients than healthy subjects. There were significant inverse correlations between these factors and age in healthy subjects, but not in ESRD patients. Although the fatigue score was not associated with any autonomic parameters, ESRD patients with impaired performance status exhibited a significantly lower LF/HF ratio. Moreover, in ESRD patients, the LF/HF ratio was significantly and positively associated with several components of QOL, including physical functioning and role emotional, independent of other clinical parameters and BMI.
  
  
  CONCLUSIONS
  Impaired autonomic function is significantly associated with fatigue and impaired QOL in dialysis patients.
authors: Center for Drug and Food Clinical Evaluation, Osaka City University Hospital, Osaka, Japan.
authors: Hisako
authors: H
authors: Fujii
authors: Hidenori
authors: H
authors: Koyama
authors: Sanae
authors: S
authors: Fukuda
authors: Hidekichi
authors: H
authors: Tokai
authors: Seiki
authors: S
authors: Tajima
authors: Jun-ichi
authors: J
authors: Koizumi
authors: Kouji
authors: K
authors: Yamaguti
authors: Hirohiko
authors: H
authors: Kuratsune
authors: Yasuyoshi
authors: Y
authors: Watanabe
authors: Yoshinobu
authors: Y
authors: Hirayama
authors: Tetsuo
authors: T
authors: Shoji
authors: Masaaki
authors: M
authors: Inaba
authors: Yoshiki
authors: Y
authors: Nishizawa
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D015995:Prevalence; D011788:Quality of Life; D006435:Renal Dialysis; D011795:Surveys and Questionnaires