Parathyroidectomy Is Associated With Reversed Nondipping Heart Rate That Impacts Mortality in Chronic Kidney Disease Patients

Chen, Ying; Huang, Hui; Ren, Wenkai; Xü, Ying; Zha, Xiaoming; Zhang, Ming; Gao, Zhenzhen; Tang, Shaowen; Yang, Guang; Huang, Yaoyu; Xu, Fan; Qian, Haoliang; Zhou, Wenbin; Ouyang, Chun; Zhang, Lína; Gao, Xueyan; Zhang, Jing; Wang, Jing; Guo, Jing; Xing, Changying; Wei, Yongyue; Wang, Ningning

doi:10.1016/j.eprac.2021.02.007

Cited by 5 publications

(5 citation statements)

References 39 publications

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“…The patients in this group constituted the training set. The inclusion criteria were as follows [ 20 ]: (1) individuals aged between 18 and 75 years old; (2) eGFR (estimated using the CKD-EPI formula) less than 15 mL/min/1.73 m 2 ; and (3) individuals who had undergone predialysis or regular dialysis for a duration of three or more months.…”

Section: Methodsmentioning

confidence: 99%

Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients

Tang,

Qian,

et al. 2024

Renal Failure

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Section: Methodsmentioning

confidence: 99%

Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients

Tang,

Qian,

et al. 2024

Renal Failure

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“…The patients in this group constituted the training set. The inclusion criteria were as follows 20 : (1) individuals aged between 18 and 75 years old; (2) eGFR (estimated using the CKD-EPI formula) less than 15 ml/min/1.73m 2 ; and (3) individuals who had undergone predialysis or regular dialysis for a duration of three or more months.…”

Section: Methodsmentioning

confidence: 99%

Predictive Model for Severe Coronary Artery Calcification in ESKD Patients

Tang,

Qian,

Zeng

et al. 2023

Preprint

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IntroductionThe Agatston coronary artery calcification score (CACS) is an assessment index for coronary artery calcification (CAC). This study aims to explore the characteristics of CAC in end-stage kidney disease (ESKD) patients and establish a predictive model to assess the risk of severe CAC in patients.MethodsCACS of ESKD patients was assessed using an electrocardiogram-gated coronary computed tomography (CT) scan with the Agatston scoring method. A predictive nomogram model was established based on stepwise regression. An independent validation cohort comprised of patients with ESKD from multicentres.Results369 ESKD patients were enrolled in the training set, and 127 patients were included in the validation set. In the training set, the patients were divided into three subgroups: no calcification (CACS = 0, n = 98), mild calcification (0 < CACS ≤ 400, n = 141) and severe calcification (CACS > 400, n = 130). Among the four coronary branches, the left anterior descending branch (LAD) accounted for the highest proportion of calcification. Stepwise regression analysis showed that age, dialysis vintage, β-receptor blocker, calcium-phosphorus product (Ca × P), and alkaline phosphatase (ALP) level were independent risk factors for severe CAC. A nomogram that predicts the risk of severe CAC in ESKD patients has been internally and externally validated, demonstrating high sensitivity and specificity.ConclusionCAC is both prevalent and severe in ESKD patients. In the four branches of the coronary arteries, LAD calcification is the most common. Our validated nomogram model, based on clinical risk factors, can help predict the risk of severe coronary calcification in ESKD patients who cannot undergo coronary CT analysis.

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“…Five-minute HRV, particularly LF, are suggested to be promising risk predictors for coronary heart disease ( Kotecha, et al, 2012 ). Compared with healthy controls, HRV parameters such as SDNN, SDANN, pNN50%, LF/HF, LF are lower in CKD patients ( Cui, et al, 2021 ; J.; Zhang, et al, 2013 ), and related with their all-cause mortality and long-term prognosis ( Mylonopoulou, et al, 2010 ; Chandra, et al, 2012 ; Kouidi, et al, 2013 ; Chang, et al, 2020 ). However, which HRV parameters are associated with all-cause mortality in CKD are controversial.…”

Section: Introductionmentioning

confidence: 96%

Nomogram Model Based on Clinical Risk Factors and Heart Rate Variability for Predicting All-Cause Mortality in Stage 5 CKD Patients

et al. 2022

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Background: Heart rate variability (HRV), reflecting circadian rhythm of heart rate, is reported to be associated with clinical outcomes in stage 5 chronic kidney disease (CKD5) patients. Whether CKD related factors combined with HRV can improve the predictive ability for their death remains uncertain. Here we evaluated the prognosis value of nomogram model based on HRV and clinical risk factors for all-cause mortality in CKD5 patients.Methods: CKD5 patients were enrolled from multicenter between 2011 and 2019 in China. HRV parameters based on 24-h Holter and clinical risk factors associated with all-cause mortality were analyzed by multivariate Cox regression. The relationships between HRV and all-cause mortality were displayed by restricted cubic spline graphs. The predictive ability of nomogram model based on clinical risk factors and HRV were evaluated for survival rate.Results: CKD5 patients included survival subgroup (n = 155) and all-cause mortality subgroup (n = 45), with the median follow-up time of 48 months. Logarithm of standard deviation of all sinus R-R intervals (lnSDNN) (4.40 ± 0.39 vs. 4.32 ± 0.42; p = 0.007) and logarithm of standard deviation of average NN intervals for each 5 min (lnSDANN) (4.27 ± 0.41 vs. 4.17 ± 0.41; p = 0.008) were significantly higher in survival subgroup than all-cause mortality subgroup. On the basis of multivariate Cox regression analysis, the lnSDNN (HR = 0.35, 95%CI: 0.17–0.73, p = 0.01) and lnSDANN (HR = 0.36, 95% CI: 0.17–0.77, p = 0.01) were associated with all-cause mortality, their relationships were negative linear. Spearman’s correlation analysis showed that lnSDNN and lnSDANN were highly correlated, so we chose lnSDNN, sex, age, BMI, diabetic mellitus (DM), β-receptor blocker, blood glucose, phosphorus and ln intact parathyroid hormone (iPTH) levels to build the nomogram model. The area under the curve (AUC) values based on lnSDNN nomogram model for predicting 3-year and 5-year survival rates were 79.44% and 81.27%, respectively.Conclusion: In CKD5 patients decreased SDNN and SDANN measured by HRV were related with their all-cause mortality, meanwhile, SDNN and SDANN were highly correlated. Nomogram model integrated SDNN and clinical risk factors are promising for evaluating their prognosis.

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Parathyroidectomy Is Associated With Reversed Nondipping Heart Rate That Impacts Mortality in Chronic Kidney Disease Patients

Cited by 5 publications

References 39 publications

Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients

Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients

Predictive Model for Severe Coronary Artery Calcification in ESKD Patients

Nomogram Model Based on Clinical Risk Factors and Heart Rate Variability for Predicting All-Cause Mortality in Stage 5 CKD Patients

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