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Open AccessArticle

The Association between Nutritional Markers and Heart Rate Variability Indices in Patients Undergoing Chronic Hemodialysis

by 1,†, 2,†, 1, 2, 2, 2, 2, 1, 1, 1, 1,3,* and on behalf of SMHGRG (Saint Mary’s Hospital Geriatric Research Group)
1
Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan
2
Department of Nursing, Saint Mary’s Hospital Luodong, No. 160, Zhongheng S. Rd., Luodong, Yilan 26546, Taiwan
3
Saint Mary’s Junior College of Medicine, Nursing and Management, No.100, Ln. 265, Sec. 2, Sanxing Rd., Sanxing Township, Yilan County 266, Taiwan
*
Author to whom correspondence should be addressed.
Those authors contributed equally to this work.
J. Clin. Med. 2019, 8(10), 1700; https://doi.org/10.3390/jcm8101700
Received: 26 August 2019 / Revised: 10 October 2019 / Accepted: 14 October 2019 / Published: 16 October 2019
(This article belongs to the Special Issue Autonomic Nervous System: From Bench to Bedside)
The associations between nutritional markers and heart rate variability (HRV) are poorly addressed. This study aimed to evaluate whether malnutrition is associated with the altered autonomic nervous system (ANS) function. This cross-sectional study was conducted enrolling 175 patients (100 women, mean age 65.1 ± 12.9 years) receiving chronic hemodialysis in a teaching hospital from June to August 2010. We performed HRV measurements before and during the index hemodialysis and compared these HRV values between two groups categorized by the individual nutritional marker. By using the multivariate generalized estimating equation with adjustment, we exhibited the independent associations between HRV and poor nutritional status defined by serum albumin < 3.8 g/dL, total cholesterol < 100 mg/dL, body mass index < 23 kg/m2, bodyweight loss within six months > 10%, bodyweight loss within three months > 5%, and normalized protein catabolic rate < 1.1 g/kg BW/day. The current study disclosed ANS impairment in hemodialysis patients with poor nutritional status. The impaired ANS function might be a potential mechanism linking malnutrition to subsequent adverse prognoses in hemodialysis patients. Further investigations are warranted to confirm these findings and clarify the causal association among this complex issue. View Full-Text
Keywords: autonomic nervous system; chronic kidney disease; heart rate variability; hemodialysis; nutritional markers; PEW syndrome autonomic nervous system; chronic kidney disease; heart rate variability; hemodialysis; nutritional markers; PEW syndrome
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MDPI and ACS Style

Wu, E.C.-H.; Huang, Y.-T.; Chang, Y.-M.; Chen, I-L.; Yang, C.-L.; Leu, S.-C.; Su, H.-L.; Kao, J.-L.; Tsai, S.-C.; Jhen, R.-N.; Shiao, C.-C.; ., on behalf of SMHGRG (Saint Mary’s Hospital Geriatric Research Group); The Association between Nutritional Markers and Heart Rate Variability Indices in Patients Undergoing Chronic Hemodialysis. J. Clin. Med. 2019, 8, 1700. https://doi.org/10.3390/jcm8101700

AMA Style

Wu EC-H, Huang Y-T, Chang Y-M, Chen I-L, Yang C-L, Leu S-C, Su H-L, Kao J-L, Tsai S-C, Jhen R-N, Shiao C-C, on behalf of SMHGRG (Saint Mary’s Hospital Geriatric Research Group). The Association between Nutritional Markers and Heart Rate Variability Indices in Patients Undergoing Chronic Hemodialysis. Journal of Clinical Medicine. 2019; 8(10):1700. https://doi.org/10.3390/jcm8101700

Chicago/Turabian Style

Wu, Eric C.-H.; Huang, Ya-Ting; Chang, Yu-Ming; Chen, I-Ling; Yang, Chuan-Lan; Leu, Show-Chin; Su, Hung-Li; Kao, Jsun-Liang; Tsai, Shih-Ching; Jhen, Rong-Na; Shiao, Chih-Chung; on behalf of SMHGRG (Saint Mary’s Hospital Geriatric Research Group). 2019. "The Association between Nutritional Markers and Heart Rate Variability Indices in Patients Undergoing Chronic Hemodialysis" J. Clin. Med. 8, no. 10: 1700. https://doi.org/10.3390/jcm8101700

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