Clinical Research Papers:
Hyperuricemia is associated with decreased changes in heart rate variability after hemodialysis in non-diabetic patients
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Abstract
Po-Chih Chen1,2, Pei-Yu Wu3,4,5, Jiun-Chi Huang3,4,5,6, Szu-Chia Chen3,4,5,6 and Yeou-Lih Huang1,2,7
1Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
2Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
3Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
4Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
5Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
6Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
7Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan
Correspondence to:
Szu-Chia Chen, email: [email protected]
Yeou-Lih Huang, email: [email protected]
Keywords: heart rate variability change before and after hemodialysis; hemodialysis; non-diabetes; uric acid
Received: September 08, 2017 Accepted: November 15, 2017 Published: January 04, 2018
ABSTRACT
Hyperuricemia has been associated with low heart rate variability (HRV), however whether there is an association between uric acid (UA) and HRV changes after hemodialysis (HD) is unknown. The aim of this study was to investigate the role of UA in HRV changes before and after HD in non-diabetic patients. Ninety-six non-diabetic patients under maintenance HD were enrolled. HRV was examined to assess changes before and after HD. A change in HRV (ΔHRV) was calculated as post-HD HRV minus pre-HD HRV. Compared to the patients with a UA level ≦ 7 mg/dL, those with a UA level > 7 mg/dL had lower ∆high frequency (HF)% (p = 0.027). UA was negatively associated with ∆HF% (r = -0.247, p = 0.015) and ∆low frequency (LF)/HF (r = -0.236, p = 0.021) in the non-diabetic patients undergoing HD. Furthermore, in multivariate analysis after adjustments for demographic, clinical, and biochemical characteristics and medications, UA was independently associated with ∆HF% (per 1 mg/dL, unstandardized coefficient β = -2.892; 95% CI, -5.066 to -0.717; p = 0.010) and ∆LF/HF (per 1 mg/dL, unstandardized coefficient β = -0.165; 95% CI, -0.291 to -0.038; p = 0.011). Hyperuricemia contributed to lesser HF% and LF/HF increase after HD in the non-diabetic patients, reflecting a state of impaired sympatho-vagal equilibrium in non-diabetic HD patients with hyperuricemia. Lowering UA levels may have the potential to improve increased HRV in non-diabetic HD patients.
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