Lower potassium and phosphorus level changes during hemodialysis were associated with higher heart rate variability and a higher incidence of arrhythmic events (p<0.001).
Observational (n=50)
Does real-time heart rate variability predict hemodialysis efficiency (electrolyte changes) in patients with end stage kidney disease?
p-value: p=<0.001
Background: Autonomic neuropathy commonly arises as a long-term complication in end stage kidney disease (ESKD) and can be diagnosed from heart rate variability (HRV), calculated from electrocardiogram (ECG) recordings. There is limited data about HRV using real-time ECG to predict HD efficiency in patients with ESKD who are routinely doing HD in real-world practice. Methods: Total of 50 patients (62.1 ± 10.7 years) with ESKD underwent continuous real-time ECG monitor (237.4 ± 15.3 min) during HD for HRV using remote monitoring system and checked electrolyte levels before/after HD. And we compared HRV according to electrolyte levels. Results: During the monitor, we checked total 2374 times of ECG and electrolyte level simultaneously of all patients. Both time and frequency domain HRV were higher when the patients had lower K+ level (lt;0.5 mEq/L) and P+ level change (lt;2 mEq/L) before/after HD as compared with those with higher K+ level (≥0.5 mEq/L) and P+ level (≥2 mEq/L) change respectively. In addition, there were higher incidence of arrhythmic events including atrial/ventricular premature complexes, even though no difference of mean heart rate in patients with lower K+ and P+ level change group (p lt; 0.001). Conclusions: Higher HRV was independently associated with poor controlled K+ and P+ level during hemodialysis in patients with ESKD. This is further substantiated by independent continuous associations between real-time measures of higher HRV and K+ and P+ level. These data strongly suggest that cardiac autonomic dysfunction can be caused by lower change of electrolytes before/after hemodialysis alone.
Im et al. (2024) conducted an observational in End Stage Kidney Disease (ESKD) (n=50). Lower K+ (<0.5 mEq/L) and P+ (<2 mEq/L) level change before/after hemodialysis vs. Higher K+ (≥0.5 mEq/L) and P+ (≥2 mEq/L) level change was evaluated on Heart rate variability and incidence of arrhythmic events (p=<0.001). Lower potassium and phosphorus level changes during hemodialysis were associated with higher heart rate variability and a higher incidence of arrhythmic events (p<0.001).