Effects of Dialysis Modality on Heart Rate Variability

OBJECTIVE: Patients with chronic kidney disease have a worse prognosis and carry a high risk of cardiovascular death and in particular sudden cardiac death. Reduced heart rate variability predicted an increased risk of mortality in non-dialysis chronic kidney disease and patients on chronic dialysis treatment. MATERIAL and METHODS: In this sectional study, we analysed heart rate variability of 28 patients with chronic kidney disease on dialysis therapy compared to a healthy control group. Heart rate variability was measured with 24-hour Holter electrocardiography. The results were compared to 30 healthy controls. RESULTS: The patients with chronic kidney disease on dialysis therapy had significantly lower heart rate variability compared to control subjects (for SDNN and pNN50; 95.4±31.5 vs. 127.5±38.8; p=0.001 and 8.3±6.1 vs. 16±9; p<0.001, respectively). There was no difference in terms of heart rate variability among hemodialysis and peritoneal dialysis modalities (for SDNN and PNN50, 90.7±32 vs. 102.5±30.8, p=0.32 and 8.6±6.3 vs. 7.8±6, p= 0.71, respectively). CONCLUSION: Reduced autonomic function may be one of the factors for cardiovascular events in patients with chronic kidney disease on dialysis therapy. There were no differences between hemodialysis and peritoneal dialysis.