Oxidative stress is associated with decreased heart rate variability in patients with chronic kidney disease |
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Authors: | Shannon B. Fadaee Kassia S. Beetham Erin J. Howden Tony Stanton Nicole M. Isbel |
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Affiliation: | 1. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia;2. Institute for Exercise and Environmental Medicine, University of Texas Southwestern Medical Centre, Dallas, USA;3. School of Medicine, The University of Queensland, Brisbane, Australia;4. Cardiovascular Imaging Research Group, The University of Queensland, Brisbane, Australia;5. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia |
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Abstract: | Objectives: Elevated oxidative stress and reduced heart rate variability (HRV) is prevalent in patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. Previous studies have identified a positive association between elevated oxidative stress and autonomic dysfunction, however this relationship has not yet been investigated in the CKD population.Methods: Plasma was collected from 78 patients with stage 3–4 CKD (estimated glomerular filtration rate 25–60?ml/min/1.73?m2) for the assessment of oxidative stress, including plasma total F2-isoprostanes, glutathione peroxidase activity and total antioxidant capacity. Time and frequency HRV parameters were measured from a three lead electrocardiogram.Results: Participants with elevated F2-isoprostanes had reduced HRV compared to patients with normal levels of F2-isoprostanes. A number of HRV parameters were found to be inversely correlated with F2-isoprostanes in all CKD patients, including SDNN (r?=??0.337; P?0.01), VLF (r?=??0.281, P?=?0.01), LF (r?=??0.315, P?0.01) and total power (r?=??0.288, P?=?0.01). Multiple linear regression found F2-isoprostanes to be an independent predictor of SDNN (r2?=?0.287, β?=??0.272, P?=?0.01).Discussion: Oxidative stress is significantly and independently associated with HRV in patients with CKD. Identifying oxidative stress in the pathogenesis of autonomic dysfunction may help target therapeutic strategies. |
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Keywords: | Autonomic dysfunction Chronic kidney disease Heart rate variability Oxidative stress |
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