Abstract 12033: Heart Rate and Estimated Glomerular Filtration Rate Decline in Kidney Transplant Recipients

Abstract

Introduction: Heart rate (HR) is one of the biomarkers reflecting sympathetic nervous system. It has been showed to be associated with decline in kidney function in general population. We aim to examine association between HR and change in estimated glomerular filtration rate (eGFR) in kidney transplant recipients (KTR). Hypothesis: We hypothesize that the higher HR is associated with more rapid decline in eGFR in KTR. Methods: A single center retrospective cohort study was conducted to examine association between mean HR among 4 office visits at 12-, 24-, 36-, and 48-weeks post-transplant and rate of eGFR change between 12- and 48-weeks post-transplantation by using multiple linear regression. In addition, association of the mean HR with rapid eGFR change defined as eGFR decline beyond a median eGFR change between 12- and 48-weeks post-transplantation of the unadjusted study population was tested by using multiple logistic regression. Results: Of all 105 KTR, mean age±SD was 54.33±11.60 years old and 61% was female. Median HR was 76/minute (IQR 69.5, 82.75). Mean eGFR were 57.23±1.74 and 60.58±1.89 ml/min/1.73 m 2 at 12 and 48 weeks, respectively with an increase in mean eGFR of -3.35±1.43 ml/min/1.73 m 2 (p 0.0211). Median rate of eGFR change was 4.31 ml/min/1.73 m 2 /year (IQR -5.75, 15.39). Every 1 beat/minute increase in HR was associated with a decline in eGFR of 0.3 ml/min/1.73 m 2 /year (β -0.297, p 0.093, 95%CI -0.644936, 0.0507214) and 1.01 time higher the odds of rapid change in eGFR (OR 1.007, p 0.662, 95%CI 0.9726614, 1.044582). After adjusted for age, gender, type of transplant, and induction immunosuppression, increase in 1 beat/minutes of HR was significantly associated with 0.39 ml/min/1.73 m 2 /year decline in eGFR (β -0.385, p 0.036, 95%CI -0.7456678, -0.0254736). Conclusions: Increased HR is associated with more rapid decline in eGFR in KTRs. Further studies are required elucidate underlying mechanisms by taken into account of immunological and non-immunological factors.