HRV Influence During Renal Transplantation Procedure on Long-Term Mortality

• Renal insufficiency and kidney transplant lead to autonomic nervous system activity disturbance.
• Renal transplantation is considered as a method that reduces many complications connected with CKD, including death caused by cardiac complication.
• HRV is a noninvasive and confirmed tool used for the evaluation of autonomic function and mortality risk in ESRD patients.
• HRV parameters recorded in the perioperative period are not optimal stratification tools for estimating the risk of cardiac death in ESRD patients.

BackgroundThe autonomic nervous system plays an important role in heart function regulation. One of the most acknowledged methods for noninvasive measurement of autonomic system activity is to determine heart rate variability (HRV). Reduced HRV parameters—heart rate rigidity/stiffness—are an independent prognostic factor of sudden cardiac death risk because of arrhythmia. Renal transplantation is an important factor in HRV changes because of hemodynamic and ion disturbances. The main purpose of this study was to determine the influence of HRV disturbances during renal transplantation procedures on long-term mortality in patients with chronic kidney disease.MethodsA prospective observation study was performed in the Department of Anesthesiology, Intensive Care, and Acute Poisoning, Pomeranian Medical University, Szczecin, Poland. There were 75 patients (mean age, 47 ± 12 years; 42 men) treated with renal transplantation between 2008 and 2010. Patients were monitored with electrocardiographic tracing with the use of 7 electrodes in position type B. The final stage of analysis was to determine the possible relationship between HRV parameters during the perioperative period and the number of deaths within a 5-year follow-up.ResultsHRV parameters during the perioperative period of renal transplantation and the number of deaths within a 5-year follow-up, measured by use of the Holter method, did not differ among patients in the studied population.ConclusionsHRV is a noninvasive and confirmed tool used for the evaluation of autonomic function and mortality risk in patients with end-stage renal disease. HRV parameters recorded in the perioperative period are not optimal stratification tools for estimating the risk of cardiac deaths in patients with end-stage renal disease.