Heart Rate Variability in Patients with Diabetic Nephropathy

• Published in: Kidney (Springer International (Firm)) Vol. 18; no. 5; pp. 241 - 246
• Main Authors: Waked, Emam, Metwaly, Amna, Allah, Emad Abd, Assal, Heba Sayed, Younes, Khaled
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.09.2009
• Subjects: Medicine; Medicine & Public Health; Nephrology; Urology; Diabetic nephropathy; Haemodialysis; Heart rate variability; Cardiovascular autonomic neuropathy
• ISSN: 0940-7936; 1865-5068
• DOI: 10.1007/s00596-009-0094-1

Background Patients with diabetic nephropathy are likely to have neurological complications including cardiovascular autonomic dysfunction, which is related to increased risk of mortality and it probably had an earlier onset and may precede the appearance of autonomic symptoms. The aim of this study was to assess cardiovascular autonomic functions by using heart rate variability analysis and its relationship with left ventricular function in type 2 diabetic patients with and without nephropathy. Materials and Methods This study was conducted on 45 diabetic patients, 15 without nephropathy, 15 with nephropathy and 15 diabetic nephropathy on hemodialysis, as well as 15 age- and sex-matched healthy controls. All of them were subjected to analysis of heart rate variability (HRV) by Holter ECG, Echocardiography, and analysis of the lipid profile. Results All time domain and frequency domain measures of HRV were significantly reduced in diabetic patients with and without nephropathy compared to healthy controls ( p  < 0.0001). There was a significant decrease in ejection fraction (EF) and increase in left ventricular mass index (LVMI) in diabetic patients with and without nephropathy compared to healthy controls ( p  < 0.0001). Also there was a significant increase in cholesterol, triglycerides and LDL with significant decrease in HDL in diabetic patients with and without nephropathy compared to healthy controls ( p  < 0.0001). Conclusion Cardiac autonomic dysfunction (as manifested by decreased HRV) was demonstrated in diabetic patients and its degree was enhanced in patients with nephropathy than in those without.