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Autonomic Heart Modulation in Chronic Kidney Disease

      Background: Dialysis is a therapeutical possibility for chronic kidney disease (CKD), and dialytic patients are often a site of comorbidities, with cardiovascular disorders among them. Heart rate variability (HRV) is a simple and non-invasive method for evaluation of heart sympathovagal regulation. Aim: Evaluation of autonomic heart modulation (AHM) in CKD patients subject to hemodialytic therapy (HDT). Methods: A group of 27 CKD patients undergoing HDT was compared to a control group of 32 otherwise healthy persons. Heart rate was collected with a Polar device, during a 20 minutes rest in a supine position, and data from the CKD group was assessed previously to HDT. HRV was analysed linearly by the square root of mean squared differences of successive NN intervals (RMSSD) and the division of the number of interval differences of successive NN intervals greater than 50 ms by number of NN intervals (pNN50), and nonlinearly by recurrence percentage (%REC), analysis of the Poincaré Plot (SD1, SD2) and Entropy. Results: Mean ages (years old) of 47.45 (±16.2) in CKD group, and 42.2 (±11.6) in control group, had no significant statistical difference (p = 0.22) between the groups. Statistically significant differences (p < 0.05) were found for HRV comparison between the groups. Conclusions: The AHM for subjects in the CKD group showed to be endangered, as shown by a lesser parasympathetic modulation, which might lead to lesser lability of the heart responses for myriad adaptations and environmental challenges, be it for the uprising of new pathologies, be it for complications among those already existing.
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