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논문분류	춘계학술대회 초록집
제목	Heart rate variability may predict intradialytic hypotension
저자	Samel Park, Eunyoung Lee, Hyowook Gil, Namjun Cho, Chiyoung Choi
출판정보	2018; 2018(1):
키워드	intradialytic hypotension \| heart rate variability \| hemodialysis \| end-stage renal disease
초록	Objectives: Intradialytic hypotension (IDH) is an important complication associated with increased mortality in patients on prevalent hemodialysis. IDH may be due to autonomic dysfunction, and heart rate variability (HRV) analysis is a non-invasive method to estimate autonomic function. Methods: Total 83 patients participated in this prospective observational study. All patients received dialysis three times a week for at least three months without hospitalization for acute illness within a past month. HRV data were obtained for the first, the middle, and the last 30 minutes during one session of dialysis. After measurement of HRV, the occurrences of IDH were monitored for 12 sessions of hemodialysis. Results: Twelve patients were excluded, because the quality of HRV data was too low to analyze, and 8 patients were due to the occurrence of IDH during HRV measurements. It is because of that the present study is to evaluate whether HRV can predict future IDH. Consequently, data from 63 patients were analyzed. Twenty patients had experienced one or more than one IDH events during the observation period (IDH group), but 43 patients had not (non-IDH group). HRV data were compared between two group, low-frequency/ high-frequency ratio (LHR, sympathetic-to-parasympathetic ratio) component of HRV showed the statistically significant intergroup difference (p = 0.35, two-way repeated-measure ANOVA). Among the clinical parameters (age, sex, diabetes, coronary artery disease, etc.) and HRV data, only factor those with the p-value greater than 0.2 from univariate logistic regression were put into the multivariate logistic regression model. The model showed that LHR in the first 30 minutes of dialysis is a significant risk factor of IDH (p = 0.043, 1.204 (1.006 – 1.441)). ROC curve showed that the parameter may predict IDH (p = 0.032, AUC 0.668 (0.513 – 0.823)). Conclusions: LHR component of HRV, from the first 30 minutes of dialysis, may predict IDH. Table. HRV logistic regression result
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