{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:03:30Z","timestamp":1791990210454,"version":"4.4.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korean Nephrology Research Foundation","award":["2021-08-004"],"award-info":[{"award-number":["2021-08-004"]}]},{"name":"Catholic Medical Center Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Intradialytic hypotension (IDH) is the primary complication of haemodialysis (HD); however, its diverse pathophysiology and inconsistent definitions complicate its prediction. Despite attempts using the heart rate variability (HRV) test for IDH prediction, studies on its usefulness for predicting IDH diagnosed per the nadir 90 criterion are lacking. We aimed to evaluate HRV test efficacy and reproducibility in predicting IDH based on the nadir 90 criterion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Seventy patients undergoing HD participated in this multicentre prospective observational study. The HRV test was performed during non-HD periods and IDH was monitored during 12 HD sessions. IDH was diagnosed according to the nadir 90 criterion, defined as a decrease in systolic blood pressure of \u226490\u00a0mmHg during HD. After monitoring, the HRV test was repeated. An HRV\u2013IDH index was developed using multivariate logistic regression analysis employing HRV test parameters. The predictive power of the HRV\u2013IDH index was analysed using the area under the receiver operating characteristics curve (AUROC). Reproducibility was evaluated using correlation analysis of two HRV tests on the same patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 37 and 33 patients in the IDH and non-IDH groups, respectively. The HRV\u2013IDH index predicted IDH occurrence with AUROCs of 0.776 and 0.803 for patients who had experienced at least one or repeated IDH episodes, respectively. Spearman's correlation coefficient for HRV\u2013IDH indices was 0.859 for the first and second HRV tests.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The HRV test holds promise for predicting IDH, particularly for patients with recurring IDH diagnosed based on the nadir 90 criterion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfae102","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T17:27:15Z","timestamp":1712597235000},"source":"Crossref","is-referenced-by-count":7,"title":["Usefulness of the heart rate variability test in predicting intradialytic hypotension in patients undergoing chronic haemodialysis"],"prefix":"10.1093","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7416-1841","authenticated-orcid":false,"given":"Yohan","family":"Park","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, College of Medicine, Konyang University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, College of Medicine, Konyang University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se-Hee","family":"Yoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, College of Medicine, Konyang University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Min","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, College of Medicine, Konyang University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Ro","family":"Yun","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Konyang University Hospital, College of Medicine, Konyang University , Daejeon , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Young","family":"Son","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0048-5717","authenticated-orcid":false,"given":"Byung Ha","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Min","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"key":"2024061409003372100_bib1","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1093\/ckj\/sfaa070","article-title":"Intradialytic hypotension and relationship with cognitive function and brain morphometry","volume":"14","author":"Cede\u00f1o","year":"2021","journal-title":"Clin Kidney J"},{"key":"2024061409003372100_bib2","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1681\/ASN.2010101119","article-title":"Intradialytic hypotension and vascular access thrombosis","volume":"22","author":"Chang","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"2024061409003372100_bib3","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1093\/ckj\/sfab124","article-title":"Comparison of intradialytic blood pressure metrics as predictors of all-cause mortality","volume":"14","author":"Kim","year":"2021","journal-title":"Clin Kidney J"},{"key":"2024061409003372100_bib4","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.2215\/CJN.02680314","article-title":"Intradialytic hypotension and risk of cardiovascular disease","volume":"9","author":"Stef\u00e1nsson","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"2024061409003372100_bib5","doi-asserted-by":"crossref","DOI":"10.23876\/j.krcp.22.291","article-title":"Intrinsic prefrontal functional connectivity according to cognitive impairment in patients with end-stage renal disease","author":"Park","year":"2023","journal-title":"Kidney Res Clin Pract"},{"key":"2024061409003372100_bib6","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/sdi.12781","article-title":"Intradialytic hypotension and splanchnic shifting: integrating an overlooked mechanism with the detection of ischemia-related signals during hemodialysis","volume":"32","author":"Daugirdas","year":"2019","journal-title":"Semin Dial"},{"key":"2024061409003372100_bib7","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1038\/ki.2010.383","article-title":"Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality","volume":"79","author":"Flythe","year":"2011","journal-title":"Kidney Int"},{"key":"2024061409003372100_bib8","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1093\/ckj\/sfaa078","article-title":"An update review of intradialytic hypotension: concept, risk factors, clinical implications and management","volume":"13","author":"Kanbay","year":"2020","journal-title":"Clin Kidney J"},{"key":"2024061409003372100_bib9","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1038\/sj.ki.5000186","article-title":"Longer treatment time and slower ultrafiltration in hemodialysis: associations with reduced mortality in the DOPPS","volume":"69","author":"Saran","year":"2006","journal-title":"Kidney Int"},{"issue":"4 Suppl 3","key":"2024061409003372100_bib10","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients","volume":"45","author":"K\/DOQI Workgroup","year":"2005","journal-title":"Am J Kidney Dis"},{"key":"2024061409003372100_bib11","doi-asserted-by":"crossref","first-page":"c241","DOI":"10.1159\/000328072","article-title":"Renal Association clinical practice guideline on haemodialysis","volume":"118","author":"Mactier","year":"2011","journal-title":"Nephron Clin Pract"},{"key":"2024061409003372100_bib12","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/ndt\/gfx037","article-title":"Intradialytic hypotension, blood pressure changes and mortality risk in incident hemodialysis patients","volume":"33","author":"Chou","year":"2018","journal-title":"Nephrol Dial Transplant"},{"key":"2024061409003372100_bib13","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/hdi.12138","article-title":"Intradialytic hypotension: frequency, sources of variation and correlation with clinical outcome","volume":"18","author":"Sands","year":"2014","journal-title":"Hemodial Int"},{"key":"2024061409003372100_bib14","doi-asserted-by":"crossref","first-page":"611","DOI":"10.23876\/j.krcp.21.153","article-title":"The importance of muscle mass in predicting intradialytic hypotension in patients undergoing maintenance hemodialysis","volume":"41","author":"Son","year":"2022","journal-title":"Kidney Res Clin Pract"},{"key":"2024061409003372100_bib15","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1681\/ASN.2014020222","article-title":"Association of mortality risk with various definitions of intradialytic hypotension","volume":"26","author":"Flythe","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"2024061409003372100_bib16","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2215\/CJN.12141017","article-title":"Mechanisms, clinical implications, and treatment of intradialytic hypotension","volume":"13","author":"Reeves","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4 Suppl 1","key":"2024061409003372100_bib17","doi-asserted-by":"crossref","first-page":"S118","DOI":"10.1053\/ajkd.2001.27418","article-title":"Autonomic dysfunction in uremia","volume":"38","author":"Savica","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"2024061409003372100_bib18","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1016\/j.numecd.2021.03.016","article-title":"Clinical significance of heart rate variability for the monitoring of cardiac autonomic neuropathy in end-stage renal disease patients","volume":"31","author":"Min","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2024061409003372100_bib19","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1161\/01.CIR.93.5.1043","article-title":"Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology","volume":"93","author":"Camm","year":"1996","journal-title":"Circulation"},{"key":"2024061409003372100_bib20","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1007\/s11517-006-0119-0","article-title":"Heart rate variability: a review","volume":"44","author":"Rajendra Acharya","year":"2006","journal-title":"Med Biol Eng Comput"},{"key":"2024061409003372100_bib21","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1038\/s41598-019-39295-y","article-title":"Predicting intradialytic hypotension using heart rate variability","volume":"9","author":"Park","year":"2019","journal-title":"Sci Rep"},{"key":"2024061409003372100_bib22","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1007\/s10157-015-1189-9","article-title":"Heart rate variability is an indicator for intradialytic hypotension among chronic hemodialysis patients","volume":"20","author":"Chang","year":"2016","journal-title":"Clin Exp Nephrol"},{"key":"2024061409003372100_bib23","doi-asserted-by":"crossref","first-page":"6074","DOI":"10.3390\/app10176074","article-title":"Heart rate variability assessment using time\u2013frequency analysis in hypotensive and non-hypotensive patients in hemodialysis","volume":"10","author":"Becerra-Luna","year":"2020","journal-title":"Appl Sci"},{"key":"2024061409003372100_bib24","doi-asserted-by":"crossref","first-page":"1196750","DOI":"10.3389\/fnins.2023.1196750","article-title":"Evaluation of autonomic nervous system activity in intradialytic hypotension using entropy and skin sympathetic nerve activity","volume":"17","author":"Li","year":"2023","journal-title":"Front Neurosci"},{"key":"2024061409003372100_bib25","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1007\/s10439-015-1502-5","article-title":"Smart ECG monitoring patch with built-in R-peak detection for long-term HRV analysis","volume":"44","author":"Lee","year":"2016","journal-title":"Ann Biomed Eng"},{"key":"2024061409003372100_bib26","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1093\/ndt\/gfp517","article-title":"Evaluation of clinical dry weight assessment in haemodialysis patients using bioimpedance spectroscopy: a cross-sectional study","volume":"25","author":"Passauer","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"2024061409003372100_bib27","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.cmpb.2013.07.024","article-title":"Kubios HRV\u2014heart rate variability analysis software","volume":"113","author":"Tarvainen","year":"2014","journal-title":"Comp Methods Programs Biomed"},{"key":"2024061409003372100_bib28","doi-asserted-by":"crossref","DOI":"10.1201\/9781439800225","volume-title":"ROC curves for continuous data","author":"Krzanowski","year":"2009"},{"key":"2024061409003372100_bib29","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1159\/000500877","article-title":"The prevalence of intradialytic hypotension in patients on conventional hemodialysis: a systematic review with meta-analysis","volume":"49","author":"Kuipers","year":"2019","journal-title":"Am J Nephrol"},{"key":"2024061409003372100_bib30","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1097\/MNH.0000000000000271","article-title":"Intradialytic hypotension","volume":"25","author":"Gul","year":"2016","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"2024061409003372100_bib31","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/sdi.12486","article-title":"We lower blood flow for intradialytic hypotension","volume":"29","author":"Sherman","year":"2016","journal-title":"Semin Dial"},{"key":"2024061409003372100_bib32","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1093\/ndt\/gfv316","article-title":"Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis","volume":"30","author":"Schytz","year":"2015","journal-title":"Nephrol Dial Transplant"},{"key":"2024061409003372100_bib33","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1172\/JCI116037","article-title":"Paradoxical withdrawal of reflex vasoconstriction as a cause of hemodialysis-induced hypotension","volume":"90","author":"Converse","year":"1992","journal-title":"J Clin Invest"},{"key":"2024061409003372100_bib34","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.ekir.2019.01.001","article-title":"Cumulative exposure to frequent intradialytic hypotension associates with new-onset dementia among elderly hemodialysis patients","volume":"4","author":"Assimon","year":"2019","journal-title":"Kidney Int Rep"},{"key":"2024061409003372100_bib35","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1186\/s12882-023-03263-6","article-title":"Impact of frequent intradialytic hypotension on quality of life in patients undergoing hemodialysis","volume":"24","author":"Wang","year":"2023","journal-title":"BMC Nephrol"},{"key":"2024061409003372100_bib36","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1053\/j.ajkd.2015.07.015","article-title":"KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update","volume":"66","author":"National Kidney Foundation","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"2024061409003372100_bib37","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1042\/cs0920351","article-title":"Autonomic nervous function during haemodialysis assessed by spectral analysis of heart-rate variability","volume":"92","author":"Cavalcanti","year":"1997","journal-title":"Clin Sci (Lond)"},{"key":"2024061409003372100_bib38","first-page":"323","article-title":"A randomized crossover clinical trial of sertraline for intradialytic hypotension","volume":"9","author":"Razeghi","year":"2015","journal-title":"Iran J Kidney Dis"},{"key":"2024061409003372100_bib39","doi-asserted-by":"crossref","first-page":"949","DOI":"10.3390\/medicina57090949","article-title":"Use of sertraline in hemodialysis patients","volume":"57","author":"Kubanek","year":"2021","journal-title":"Medicina (Kaunas)"},{"key":"2024061409003372100_bib40","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1440-1797.2003.00216.x","article-title":"Addition of sertraline to other therapies to reduce dialysis-associated hypotension","volume":"8","author":"Brewster","year":"2003","journal-title":"Nephrology (Carlton)"},{"key":"2024061409003372100_bib41","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1046\/j.1523-1755.2001.00074.x","article-title":"Assessing fluid change in hemodialysis: whole body versus sum of segmental bioimpedance spectroscopy","volume":"60","author":"Chanchairujira","year":"2001","journal-title":"Kidney Int"},{"key":"2024061409003372100_bib42","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/00002480-200207000-00009","article-title":"Central, peripheral, and other blood volume changes during hemodialysis","volume":"48","author":"Prakash","year":"2002","journal-title":"ASAIO J"},{"key":"2024061409003372100_bib43","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1159\/000504245","article-title":"Association of body composition and intradialytic hypotension in hemodialysis patients","volume":"49","author":"Tian","year":"2020","journal-title":"Blood Purif"},{"key":"2024061409003372100_bib44","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/j.1540-8175.2008.00885.x","article-title":"Association between left atrium enlargement and intradialytic hypotension: role of diastolic dysfunction in the hemodynamic complications during hemodialysis","volume":"26","author":"Barberato","year":"2009","journal-title":"Echocardiography"},{"key":"2024061409003372100_bib45","first-page":"573","article-title":"Association between cardiac function and intradialytic hypotension","volume":"34","author":"Ye","year":"2012","journal-title":"Zhongguo Yi Xue Ke Xue Yuan Xue Bao"},{"key":"2024061409003372100_bib46","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1093\/ndt\/gfi088","article-title":"Myocardial contractility does not determine the haemodynamic response during dialysis","volume":"20","author":"Ie","year":"2005","journal-title":"Nephrol Dial Transplant"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfae102\/57184420\/sfae102.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/17\/6\/sfae102\/58232101\/sfae102.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/17\/6\/sfae102\/58232101\/sfae102.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T14:31:25Z","timestamp":1718375485000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/doi\/10.1093\/ckj\/sfae102\/7642265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,8]]},"references-count":46,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfae102","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"value":"2048-8505","type":"print"},{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,4,8]]},"article-number":"sfae102"}}