Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients

Yu Hsiang Chou, Wei Lieh Huang, Chin Hao Chang, Cheryl C.H. Yang, Terry B.J. Kuo, Shuei Liong Lin, Wen Chih Chiang, Tzong Shinn Chu

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Aim: Autonomic dysfunction contributes to cardiovascular morbidity/mortality and can be evaluated with heart rate variability (HRV). This study is to evaluate the prognostic significance of HRV on renal function in non-dialysis chronic kidney disease (CKD) patients. Methods: We enrolled 326 non-dialysis CKD patients in this prospective observational study. The median follow-up period was 2.02 years. Five-minutes of electrocardiography recordings obtained at enrolment were reprocessed to assess HRV. Five frequency-domain measures and one time-domain measures were obtained. Rapid CKD progression was defined as annual estimated glomerular filtration rate (eGFR) loss over 30% per year or eGFR decline rate over 3 mL/min per 1.73 m2 per year. The prevalence of abnormal HRV, associated factors of HRV and impact of HRV on the risk of CKD progression were analyzed. Results: The abnormality of HRV increased along with the severity of CKD. In patients with stage 5 CKD, the proportion of abnormal ln(low frequency power) (LF), ln(high frequency power) (HF), lnLF/HF were 69.5, 52.8 and 50%, respectively. Associated factors of HRV included advanced CKD, diabetes mellitus, serum albumin, severe proteinuria, Beck Anxiety Inventory score, erythropoietin use, renin-angiotensin system inhibitors and heart failure. Multivariate logistic regression model analysis revealed lower lnLF/HF, hypertension and severe proteinuria were the risk factors of rapid CKD progression. Conclusion: The prevalence of autonomic dysfunction measured by HRV among each stage CKD patients is different. Most patients in advanced CKD stage have reduced values of HRV parameters. The estimation of lnLF/HF also provided prognostic information on CKD progression in addition to classical risk factors.

Original languageEnglish
Pages (from-to)806-813
Number of pages8
Issue number8
Publication statusPublished - Aug 1 2019
Externally publishedYes


  • autonomic dysfunction
  • chronic kidney disease
  • heart rate variability
  • renal function progression

ASJC Scopus subject areas

  • Nephrology


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