Photo Credit: Ekaterina Chizhevskaya
The following is a summary of “Cardiovascular autonomic neuropathy in chronic kidney disease: a study of kidney biopsy cases,” published in the December 2024 issue of Nephrology by Kuno et al.
Cardiovascular autonomic neuropathy (CAN) is an autonomic nervous system dysfunction, with heart rate variability (HRV) serving as the primary diagnostic tool. While CAN is a known prognostic marker for adverse kidney outcomes in diabetic kidney disease (DKD), its pathogenesis in nondiabetic chronic kidney disease (CKD) remains underexplored.
Researchers conducted a retrospective study to investigate the prevalence of CAN in patients with nondiabetic CKD.
They evaluated 165 nondiabetic patients with CKD who underwent kidney biopsy between 2020 and 2023. HRV was quantified using the coefficient of variation of the RR interval (CVRR). CAN was diagnosed based on the CVRR, with the reference value defined as the 2.5 percentile point of CVRR values in healthy individuals, adjusted for age and sex.
The results showed a median age of 47.0 (34.0–57.0) years, with 50.9% male. The median eGFR was 65.0 (42.0–85.0) mL/min/1.73m2, and CVRR was 3.5 (2.4–4.7)c%. CAN was diagnosed in 16 patients (9.7%) and was associated with kidney dysfunction, dyslipidemia, and advanced IF/TA. Multivariable analysis indicated that IF/TA was independently associated with CVRR (P = 0.045).
They found that the prevalence of CAN in nondiabetic CKD patients was 9.7%, significantly higher than in healthy individuals. CAN was associated with advanced interstitial fibrosis/tubular atrophy (IF/TA) in this cohort.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03879-2
