MO501: A Nomogram Based on Heart Rate Variability Parameters for Predicting All-Cause Mortality in Stage 5 CKD Patients

Abstract

Abstract BACKGROUND AND AIMS Heart rate variability (HRV), reflecting the circadian rhythm of heart rate, is associated with clinical outcomes in stage 5 chronic kidney disease 5 (CKD5) patients. Whether CKD-related factors combined with HRV can improve the predictive ability for their death remains uncertain. Here we evaluated the prognosis value of nomogram models based on HRV for all-cause mortality in CKD5 patients. METHOD Multicenter CKD5 patients were enrolled from 2011 to 2019 in China. The multivariate Cox regression analysis screened HRV parameters, which associated with all-cause mortality. Their relationships were displayed by restricted cubic spline graphs. The predictive abilities of nomogram models were evaluated for survival rate. RESULTS CKD5 patients included survival group (n = 155) and the all-cause mortality group (n = 45), with a median follow-up time of 48 months. Logarithm of standard deviation of all sinus R–R intervals (lnSDNN) {HR: 0.35, [95% confidence interval (95% CI): 0.17–0.73]; P = .01} and logarithm of standard deviation of average NN intervals for each 5 min (lnSDANN) (HR: 0.36, 95% CI: 0.17–0.77; P = .01) were associated with all-cause mortality, their relationships were negative linear. The area under the curve (AUC) values based on lnSDNN nomogram model for predicting 3-year and 5-year survival rates were 79.44% and 81.27%, respectively. The AUC values based on lnSDANN nomogram model for predicting 3-year and 5-year survival rates were 78.73% and 80.61%, respectively. CONCLUSION As clinical indicators of heart rate circadian rhythm, SDNN and SDANN are highly correlated with the prognosis of CKD5 patients. Nomogram models that integrate HRV and multiple CKD-related risk factors are promising for evaluating their all-cause mortality.