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Effects of interdialytic interval on heart rate variability in chronic hemodialysis patients: a cross-sectional study

Kajohnsak Noppakun1,2, Phasakorn Putchagarn3, Arintaya Phrommintikul3

  • 1Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Scientific Reports
|October 23, 2021
PubMed

Insights

Longer hemodialysis intervals did not significantly alter heart rate variability overall. However, patients with diabetes mellitus showed greater autonomic dysfunction changes between dialysis sessions compared to non-diabetic patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Autonomic Neuroscience

Background:

  • Longer interdialytic intervals in chronic hemodialysis are linked to increased sudden cardiac death risk.
  • Diabetes mellitus (DM) and autonomic dysfunction are critical adverse predictors for end-stage renal disease (ESRD) patient survival.

Purpose of the Study:

  • To compare autonomic function, assessed via heart rate variability (HRV), between long and short interdialytic intervals in hemodialysis patients with and without DM.
  • To investigate the impact of DM on autonomic response to varying interdialytic periods.

Main Methods:

  • One hundred sixty-three chronic hemodialysis patients were enrolled.
  • Electrocardiogram recordings were obtained during hemodialysis sessions following both long and short interdialytic intervals to assess HRV parameters.
  • Statistical analysis compared HRV metrics between the two interval types, stratified by diabetic status.

Main Results:

  • Overall HRV parameters did not significantly differ between long and short interdialytic intervals.
  • A subset of patients (50.3%) exhibited increased HRV parameters (SDNN, ASDNN, LF) after a long interdialytic interval.
  • Patients with DM demonstrated a significantly greater alteration in HRV parameters (SDNN, ASDNN, VLF, LF) between long and short interdialytic intervals compared to non-DM patients.

Conclusions:

  • While overall HRV shows no significant difference between short and long interdialytic intervals, specific HRV parameters can be affected.
  • Diabetes mellitus patients exhibit more pronounced autonomic alterations between varying interdialytic intervals, highlighting a vulnerable subgroup in ESRD care.

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