Effects of daily hemodialysis on heart rate variability: results from the Frequent Hemodialysis Network (FHN) Daily Trial

Chan, Christopher T.; Chertow, Glenn M.; Daugirdas, John T.; Greene, Tom; Kotanko, Peter; Larive, Brett; Pierratos, Andreas; Stokes, John B.

doi:10.1093/ndt/gft212

Cited by 45 publications

(35 citation statements)

References 34 publications

(34 reference statements)

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“…Daily hemodialysis increased LF band and reduced left ventricular mass [27] . Both hemodiafiltration [28] and physical training program [29] are also beneficial.…”

Section: Discussionmentioning

confidence: 91%

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Hsueh²,

Lee³

et al. 2017

Nephron

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Background: Both cardiovascular calcification and autonomic dysfunction are frequently encountered in hemodialysis patients. We aimed to investigate the relationship between cardiovascular calcification and heart rate variability (HRV) and their influence on long-term outcome. Methods: Seventy-eight hemodialysis patients underwent echocardiogram and radiography of the pelvis and hands to identify valvular and vascular calcification. HRV was evaluated using a commercial machine. Results: Based on the average, the patients were divided into higher and lower subgroups of high frequency (HF) and low frequency (LF) respectively. Patients with higher LF were younger and were found to have a lower proportion of diabetes. Their hemoglobin, albumin, and bone morphogenic protein (BMP)-7 levels were significantly higher and both high-sensitive C-reactive protein (hs-CRP) and osteoprotegerin levels were lower (all p < 0.05). In patients of the higher HF group, the proportion of diabetes was lower but they were found to have higher levels of BMP-7 and lower levels of hs-CRP, interleukin-6 (all p < 0.05). Significantly higher LF and HF were noted in patients without vascular calcification, but only hand artery (HA) calcification was negatively correlated with both LF and HF in multivariate analysis. Low LF and high hs-CRP were the independent predictors of mortality. Coexistence of low LF band and HA calcification was associated with the worse outcome. Conclusions: Abnormal autonomic nervous function was closely related to inflammation and mortality in hemodialysis patients. Calcification of HA was associated with autonomic dysfunction and patients with lower autonomic tone and HA calcification had the highest mortality rate in this population.

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“…Daily hemodialysis increased LF band and reduced left ventricular mass [27] . Both hemodiafiltration [28] and physical training program [29] are also beneficial.…”

Section: Discussionmentioning

confidence: 91%

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Hsueh²,

Lee³

et al. 2017

Nephron

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“…Mylonopoulou et al [219], in contrast, observed enhanced HRV parameters in both diabetic and nondiabetic ESRD patients, but the effect was more pronounced in the nondiabetic population. Conversion from conventional to nocturnal hemodialysis, which allows more efficient removal of uremic toxins, was associated with improved BRS, increased HF (vagal) power of HRV, and a normalized LF/HF ratio of HRV [101,220]. A marked drop in muscle SNA in patients receiving frequent hemodialysis also was reported [221].…”

Section: Renal Replacement Therapymentioning

confidence: 97%

Cardiovascular Autonomic Dysfunction in Chronic Kidney Disease: a Comprehensive Review

Salman

2015

Curr Hypertens Rep

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Cardiovascular autonomic dysfunction is a major complication of chronic kidney disease (CKD), likely contributing to the high incidence of cardiovascular mortality in this patient population. In addition to adrenergic overdrive in affected individuals, clinical and experimental evidence now strongly indicates the presence of impaired reflex control of both sympathetic and parasympathetic outflow to the heart and vasculature. Although the principal underlying mechanisms are not completely understood, potential involvements of altered baroreceptor, cardiopulmonary, and chemoreceptor reflex function, along with factors including but not limited to increased renin-angiotensin-aldosterone system activity, activation of the renal afferents and cardiovascular structural remodeling have been suggested. This review therefore analyzes potential mechanisms underpinning autonomic imbalance in CKD, covers results accumulated thus far on cardiovascular autonomic function studies in clinical and experimental renal failure, discusses the role of current interventional and therapeutic strategies in ameliorating autonomic deficits associated with chronic renal dysfunction, and identifies gaps in our knowledge of neural mechanisms driving cardiovascular disease in CKD.

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“…It has been found that during the ultrafiltration procedure of the hemodialysis therapy an acute decrease in parasympathetic function and a relative hyperactivity of sympathetic nervous system takes place [96]. Moreover, it has been supported that daily hemodialysis induced structural effects on the heart of uremic patients which was associated with alterations in HRV [97]. In particular, ANS dysfunction worsens as the disease progresses [98,99] and the duration of hemodialysis session increases [100] while age is an important player which contributes in the parasympathetic dysfunction often seen in CKD patients [101].…”

Section: Discussion-conclusionmentioning

confidence: 97%

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

Καλτσάτου¹,

Karatzaferi²,

Mitrou³

et al. 2016

CPD

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Effects of daily hemodialysis on heart rate variability: results from the Frequent Hemodialysis Network (FHN) Daily Trial

Cited by 45 publications

References 34 publications

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Synergic Impact of Vascular Calcification and Low Autonomic Tone in Mortality of Hemodialysis Patients

Cardiovascular Autonomic Dysfunction in Chronic Kidney Disease: a Comprehensive Review

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

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