Diagnostic accuracy of Bellavere’s score in cardiac autonomic neuropathy among chronic kidney disease patients: a study of prevalence and dialysis impact

Background: Cardiac autonomic neuropathy (CAN) is a significant complication in chronic kidney disease (CKD), leading to increased morbidity and mortality. Early detection is essential for managing CKD patients effectively, especially those on hemodialysis. This study evaluated the prevalence CAN in CKD and diagnostic accuracy of Bellavere's Score in predicting CAN in CKD patients, including those undergoing hemodialysis. Methods: This prospective observational study included 200 CKD patients. Cardiac autonomic neuropathy was assessed using Bellavere's Score, calculated through a series of autonomic function tests including heart rate variability and blood pressure responses. Bellavere's Score was measured pre-and post-dialysis in hemodialysis patients. The diagnostic performance of the score was evaluated using receiver operating characteristic (ROC) curves to determine sensitivity, specificity, and likelihood ratios. Conclusion: Bellavere's Score provides a reliable and non-invasive approach for diagnosing CAN in CKD patients, with strong diagnostic performance across different disease stages and in hemodialysis. Larger studies are warranted to further validate its utility.