{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T16:34:08Z","timestamp":1786552448101,"version":"build-2736575974"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vital parameters such as respiratory rate are well-established predictors of mortality in emergency medicine. In hemodialysis patients, respiratory rate is influenced by multiple factors, including cardiovascular stress and impaired renal acid-base regulation. We hypothesized that higher respiratory rates in hemodialysis patients are associated with increased mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 364 hemodialysis patients from the ISAR cohort, a large prospective multicenter dialysis cohort, the mean nocturnal respiratory rate between 0 and 5 a.m. was derived from 24-hour Holter ECG recordings. Associations with all-cause and cardiovascular mortality at 3 and 6 years were assessed using univariate and multivariable Cox proportional hazards models, including non-linear spline modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hemodialysis patients had a mean nocturnal respiratory rate of 20.2 breaths\/minute. Individuals with higher respiratory rates were younger, had higher nocturnal heart rates, net ultrafiltration, levels of C-reactive protein, and interleukin-6. After 3 years, nocturnal respiratory rate showed a significant, U-shaped association with mortality in both univariate and multivariable analyses. Patients in the highest and lowest quartiles of respiratory rate had a 2.7-fold increased cardiovascular and a 1.4-fold increased all-cause 3-year mortality, compared to patients in the inner quartiles. The association with cardiovascular mortality was confirmed after multivariate adjustment, but was no longer apparent after 6 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hemodialysis patients exhibit a mean nocturnal respiratory rate above the physiological range, with a U-shaped association with three-year mortality. These findings may reflect increased cardiopulmonary demand in the hemodialysis population, and that nocturnal respiratory rate may provide valuable additional information for risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag206","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:32:34Z","timestamp":1784633554000},"source":"Crossref","is-referenced-by-count":0,"title":["Nocturnal Respiratory Rate Predicts 3-Year Mortality in Hemodialysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1265-1213","authenticated-orcid":false,"given":"Nora","family":"Hannane","sequence":"first","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5803-2190","authenticated-orcid":false,"given":"Christoph","family":"Schmaderer","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C","family":"Mayer","sequence":"additional","affiliation":[{"name":"Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH , Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Matschkal","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Krieter","sequence":"additional","affiliation":[{"name":"Nephrocare Munich East , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen R","family":"Braun","sequence":"additional","affiliation":[{"name":"Praxen Dr. Braun, Dialysis Center , Dingolfing ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicitas","family":"Dettenhofer","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudius","family":"K\u00fcchle","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Renders","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-3900","authenticated-orcid":false,"given":"Roman","family":"G\u00fcnthner","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Wassertheurer","sequence":"additional","affiliation":[{"name":"Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH , Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Haller","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Klinikum Rechts der Isar, Institute of AI and Informatics in Medicine, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Heemann","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Klinikum Rechts der Isar, Department of Cardiology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3692-5243","authenticated-orcid":false,"given":"Georg","family":"Schmidt","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Klinikum Rechts der Isar, Department of Cardiology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3792-1407","authenticated-orcid":false,"given":"Marek","family":"Malik","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , London ,","place":["United Kingdom"]},{"name":"Faculty of Medicine, Department of Internal Medicine and Cardiology, Masaryk University , Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias C","family":"Braunisch","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Department of Nephrology, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"container-title":["Journal of 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