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Autonomic dysfunction in uremia assessed by heart rate variability

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Abstract

Decreased heart rate variability is an independent risk factor for cardiac mortality in hemodialysis patients. Our aim was to determine whether it is already present in uremic children and young adults on hemodialysis and following renal transplantation. Twenty-two hemodialysis patients [age 17.2 years (median, quartiles 13.0–22.6)], 22 transplant patients [18.4 years (14.4–21.2)], and 29 healthy controls [16.4 years (15.7–21.1)] were examined. Heart rate and its high (HF) and low (LF) frequency variability were measured in the supine position for 10 min. High and low frequency variability was significantly reduced, whereas heart rate and LF/HF ratio was significantly elevated in both patient groups compared with controls. There was a clear-cut difference between the dialyzed and the transplanted groups based on the HF variability, with the lowest values in the dialysis group (P<0.01). LF and LF/HF data did not allow us to distinguish between the patient groups. In conclusion, heart rate variability in the HF range is a sensitive tool for detecting cardiovascular autonomic dysfunction that is already present in children and adolescents with impaired kidney function.

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Acknowledgements

This work was supported by the Hungarian National Grants OMFB (TéT D 11/2001), OTKA (T031986, F042563), and ETT (299/2000).

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Authors and Affiliations

  1. 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary

    Kálmán Tory, Zsuzsanna Süveges, Erzsébet Horváth, Éva Bokor, Péter Sallay, Attila Szabó, Tivadar Tulassay & György S. Reusz

  2. 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary

    Klára Berta

  3. 1st Department of Pediatrics, Bókay u. 53., 1083, Budapest, Hungary

    György S. Reusz

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  1. Kálmán Tory
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  2. Zsuzsanna Süveges
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Correspondence to György S. Reusz.

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Tory, K., Süveges, Z., Horváth, E. et al. Autonomic dysfunction in uremia assessed by heart rate variability. Pediatr Nephrol 18, 1167–1171 (2003). https://doi.org/10.1007/s00467-003-1280-4

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  • DOI: https://doi.org/10.1007/s00467-003-1280-4

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