Why the study?
Long interdialytic interval increases sudden cardiac death risk compared to short interval in chronic hemodialysis, and DM and autonomic dysfunction predict adverse survival in ESRD.
Does a long interdialytic interval alter heart rate variability compared to a short interdialytic interval in chronic hemodialysis patients with and without diabetes mellitus?
Does a long interdialytic interval alter heart rate variability compared to a short interdialytic interval in chronic hemodialysis patients with and without diabetes mellitus?
While heart rate variability does not differ between short and long interdialytic intervals in the overall hemodialysis population, patients with diabetes exhibit greater autonomic alteration after a long interdialytic interval.
HRV unchanged overall across intervals; greater DM-linked shifts remain hypothesis-generating for targeted SCD risk assessment.
Previous studies showed that long interdialytic interval of chronic hemodialysis increased risk of sudden cardiac death compared to short interdialytic interval. Diabetes mellitus (DM) and autonomic dysfunction are the strong adverse predictors of survival in ESRD patients. We aimed to compare autonomic function between long and short interdialytic interval of chronic hemodialysis in patients with and without DM. One-hundred sixty-three patients receiving chronic hemodialysis were enrolled. The electrocardiogram recording was performed twice in each patient during 4-h hemodialysis session after long and short interdialytic intervals to assess heart rate variability (HRV). Mean age was 61.4 ± 14.3 years. HRV parameters during hemodialysis did not differ between long and short interdialytic interval in overall population. Nevertheless, in 82 (50.3%) patients, SDNN (47.4 ± 23.8 vs. 43.4 ± 19.5 ms, P = 0.039), ASDNN (24.8 ± 14.3 vs. 22.7 ± 12.3 ms, P = 0.025), LF (8.4 ± 6.8 vs. 7.6 ± 6.6 ms 2 , P = 0.040) increased after long interdialytic interval. The greater change of SDNN, ASDNN, VLF and LF between long and short interdialytic intervals was noted in DM, compared to non-DM patients. We demonstrated that there was no difference of HRV parameters after short and long interdialytic interval. However, there was greater autonomic alteration observed in DM than non-DM patients between 2 interdialytic intervals.
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Noppakun et al. (2021) studied this question.
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