Abstract
Background: Heart rate variability (HRV) represents changes in the time between successive heart beats, and it has been used to assess the autonomic nervous system. Previous studies have reported autonomic dysfunction in diabetic patients undergoing hemodialysis (HD), however, no studies have evaluated the effects of age on changes in HRV in these patients. The aim of this study was to examine the effects of age on changes in HRV in diabetic HD patients.Methods: We enrolled 84 diabetic patients receiving maintenance HD. HRV was measured before and after HD to assess changes in HRV (ΔHRV). The patients were divided into two groups based on their age (65 years< or ≥65 years).Results: Compared to the patients aged <65 years, those aged ≥65 years had a higher high frequency (HF) % (p = 0.032) before HD. The patients aged <65 years had a significant increase in very low frequency, low frequency (LF), and HF after HD. The patients aged ≥65 years had a significant increase in LF, but a significant decrease in HF% after HD. There was a significant interaction between age and change of HF% (p = 0.023) after HD. After multivariate adjustments for clinical, biochemical data and medications, systolic blood pressure, total cholesterol, hemoglobin, and hemoglobin were associated with ΔLF, whereas cerebrovascular disease, systolic blood pressure, and fasting glucose were associated with ΔHF% in patients aged ≥65 years.Conclusion: Our study demonstrated significant changes in HRV after HD in diabetic patients. In the patients aged ≥65 years, LF was increased, whereas HF% was decreased significantly after HD. Among the HRV parameters, age had an interaction with the change of HF%.
Highlights
Heart rate variability (HRV) is a non-invasive method of measuring variations in heart rate, and it can be used to evaluate cardiovascular (CV) autonomic neuropathy and activities of the autonomic nervous system (Camm et al, 1996)
Among all of the pre-dialysis HRV parameters, only high frequency (HF)% was significantly higher in the patients ≥65 years of age compared to those
Cerebrovascular disease, fasting glucose, hemoglobin, beta-blocker use and ultrafiltration rate were significantly associated with HRV in the patients
Summary
Heart rate variability (HRV) is a non-invasive method of measuring variations in heart rate, and it can be used to evaluate cardiovascular (CV) autonomic neuropathy and activities of the autonomic nervous system (Camm et al, 1996). A previous study reported that HD patients with diabetes had a smaller degree of changes in HRV after HD than patients without diabetes, and that this may be related to diabetic autonomic neuropathy (Zitt et al, 2008). Previous studies have reported autonomic dysfunction in diabetic patients undergoing hemodialysis (HD), no studies have evaluated the effects of age on changes in HRV in these patients. The aim of this study was to examine the effects of age on changes in HRV in diabetic HD patients
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