Characterization of heart rate variability in end-stage renal disease patients after kidney transplantation with recurrence quantification analysis
Amara Hazel Solorio-Rivera, Martín Calderón-Juárez, Jesús Arellano-Martínez, Claudia Lerma, Gertrudis Hortensia González-Gómez
Abstract
Heart rate variability (HRV) is a noninvasive approach to studying the autonomic modulation of heart rate in experimental settings, such as active standing sympathetic stimulation. It is known that patients with end-stage renal disease during active standing have few changes in HRV dynamics, which are improved after hemodialysis.
Introduction
Heart rate variability (HRV) is the instantaneous change in heart rate. These heart rate variations are tightly related to respiratory and autonomic modulations of the cardiovascular system [1]. In end-stage renal disease (ESRD), patients who are treated with hemodialysis show chronic sympathetic hyperactivity that produces decreased HRV modulation with a predominance of low-frequency oscillations and a blunted HRV response to active standing [2]. However, cardiac autonomic modulation and baroreflex sensitivity improve after renal transplantation [3].
Materials and methods
We included 16 patients with kidney transplantation who were recruited during follow-up consultation in a second-level hospital in Mexico with a median age of 32 [27–35] years old and with equal number of males and females. All patients had a stable functional allograft at the time of recruitment with a median creatinine of 1.1 [0.8–1.4] mg/dL and an estimated glomerular filtration rate of 73.5 [58.2–89.5] mL/min/1.73m
Result
power spectral density (PSD), and recurrence plots of one subject in the supine position and active standing. The values of time domain indices, meanNN, SDNN, SDSD, and pNN20 are larger in the supine position than active standing
Discussion
This work shows the evaluation of HRV during active standing tests using traditional HRV indices and nonlinear RQA measures in kidney transplant recipients. We found a significant change in almost all HRV indices, as well as a predominance of vertical structures in HRV recurrence plots during active standing.
Conclusion
HRV of kidney recipients shows a diminished variability during active standing, compared to the supine position. The dynamic behavior of HRV also changed in response to active standing with a predominance of vertical structures in recurrence plots
Citation: Solorio-Rivera AH, Calderón-Juárez M, Arellano-Martínez J, Lerma C, González-Gómez GH (2024) Characterization of heart rate variability in end-stage renal disease patients after kidney transplantation with recurrence quantification analysis. PLoS ONE 19(5): e0299156. https://doi.org/10.1371/journal.pone.0299156
Editor: Choon-Hian Goh, Universiti Tunku Abdul Rahman, MALAYSIA
Received: January 26, 2023; Accepted: February 6, 2024; Published: May 1, 2024
Copyright: © 2024 Solorio-Rivera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0299156#abstract0
