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HRV Influence During Renal Transplantation Procedure on Long-Term Mortality.

J Biernawska¹, K Kotfis¹, M Kaczmarczyk²

¹Department of Anesthesiology, Intensive Care, and Acute Poisoning, Teaching Hospital No. 2, Pomeranian Medical University, Szczecin, Poland.

Transplantation Proceedings

|August 7, 2016

Summary

Heart rate variability (HRV) assessment during renal transplantation did not predict long-term cardiac death risk in chronic kidney disease patients. This study found no significant difference in HRV parameters between survivors and non-survivors within a 5-year follow-up period.

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Area of Science:

Cardiology
Nephrology
Autonomic Nervous System Research

Background:

Autonomic nervous system (ANS) regulates heart function; heart rate variability (HRV) noninvasively measures ANS activity.
Reduced HRV (heart rate rigidity/stiffness) is a risk factor for sudden cardiac death due to arrhythmia.
Renal transplantation impacts HRV due to hemodynamic and ionic changes.

Purpose of the Study:

To investigate the influence of HRV disturbances during renal transplantation on long-term mortality in chronic kidney disease (CKD) patients.
To assess the prognostic value of perioperative HRV parameters for cardiac mortality after renal transplantation.

Main Methods:

Prospective observational study of 75 renal transplant patients (2008-2010).
Electrocardiographic monitoring with 7 electrodes.
Analysis of the relationship between perioperative HRV and 5-year mortality.

Main Results:

No significant differences in HRV parameters were observed during the perioperative period of renal transplantation.
Perioperative HRV measurements did not correlate with the number of deaths within the 5-year follow-up.

Conclusions:

HRV is a validated tool for assessing autonomic function and mortality risk in end-stage renal disease (ESRD).
Perioperative HRV parameters are not optimal for stratifying cardiac death risk in ESRD patients undergoing renal transplantation.