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Heart rate variability predicts ESRD and CKD-related hospitalization.

TitleHeart rate variability predicts ESRD and CKD-related hospitalization.
Publication TypeJournal Article
Year of Publication2010
AuthorsBrotman DJ, Bash LD, Qayyum R, Crews D, Whitsel EA, Astor BC, Coresh J
JournalJ Am Soc Nephrol
Volume21
Issue9
Pagination1560-70
Date Published2010 Sep
ISSN1533-3450
KeywordsAlbuminuria, Autonomic Nervous System, Chronic Disease, Female, Heart Rate, Hospitalization, Humans, Kidney Diseases, Kidney Failure, Chronic, Longitudinal Studies, Male, Middle Aged
Abstract

Autonomic imbalance, a feature of both diabetes and hypertension, may contribute to adverse cardiovascular outcomes. In animal models, sympathetic nerve activity contributes to renal damage but the extent to which autonomic dysfunction precedes the development of CKD and ESRD in humans is unknown. We measured resting heart rate and heart rate variability in 13,241 adults (45- to 64-years old) followed for a median of 16 years in the Atherosclerosis Risk in Communities (ARIC) Study. We examined heart rate parameters by quartiles, defining those in the lowest quartile (by time and frequency domain measures separately) as the risk group of interest. We identified 199 cases of incident ESRD and 541 patients with CKD-related hospitalizations; higher resting heart rate and lower heart rate variability associated with both outcomes. The fully adjusted hazard ratios for ESRD were 1.98 (95% confidence interval [CI] 1.45 to 2.70) among those in the highest heart rate quartile and 1.56 (95% CI 1.14 to 2.14) for high-frequency power. Other time and frequency domain measures were similarly and significantly associated with ESRD and CKD-related hospitalizations. These results suggest that autonomic dysfunction may be an important risk factor for ESRD and CKD-related hospitalizations and call for further studies to define the mechanisms that underlie these associations.

DOI10.1681/ASN.2009111112
Alternate JournalJ Am Soc Nephrol
PubMed ID20616169
PubMed Central IDPMC3013524
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
1KL2RR025006 / RR / NCRR NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
T32-HL-007024 / HL / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
1KL2RR025006-01 / RR / NCRR NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
KL2 RR025006 / RR / NCRR NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
R01 DK076770 / DK / NIDDK NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States