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Cardiac Dysautonomia in Patients on Chronic Hemodialysis ; One Year Follow up Study

Cardiac Dysautonomia in Patients on Chronic Hemodialysis ; One Year Follow up Study. Hafiz I. Ahmad MD, FASN* 1 , Arif Asif MD, FASN 3 , Syed Rizwan Bokhari MD 1 , Muhammad Zaman Khan Assir MBBS 2 , Muhammad Awais MBBS 1 and Sabin Nasir MBBS 1 .

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Cardiac Dysautonomia in Patients on Chronic Hemodialysis ; One Year Follow up Study

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  1. Cardiac Dysautonomia in Patients on Chronic Hemodialysis ; One Year Follow up Study Hafiz I. Ahmad MD, FASN*1, Arif Asif MD, FASN3, Syed Rizwan Bokhari MD1, Muhammad Zaman Khan Assir MBBS2, Muhammad Awais MBBS1 and Sabin Nasir MBBS1. 1- Department of Nephrology and 2Department of Medicine, Allama Iqbal Medical College / Jinnah Hospital, Lahore, Pakistan; 3Division of Nephrology, University of Miami School of Medicine, Miami, FL, United States. Background Cardiac dysautonomia has been shown to be associated with increased frequency of cardiac arrhythmias. However, frequency of new onset cardiac dysautonomia in dialysis patients is not known. Last year we conducted a trial on our dialysis population and found cardiac dysautonomia in majority of patients (Ahmad et al ASN 2011). Methods We conducted a prospective study on cohort of fifty chronic hemodialysis patients. Of these thirty eight (76%) patients were alive at end of one year. These patients underwent three tests of cardiac autonomic dysfunction at base line and at end of 1 year follow up. These tests included abnormal heart rate response to deep breathing (E:I ratio less than 1.17), abnormal Valsalva ratio (longest to shortest R-R ratio less than 1.2) and abnormal 30:15 ratio (30th to 15th R-R ratio on standing less than 1.03). Patients with 2 or more abnormal tests were considered to be having cardiac dysautonomia. (12%) patients who did not have cardiac dysautonomia at baseline, five (83%) patients developed cardiac dysautonomia at the end of one year. One (17%) patient was excluded from analysis due to inability to perform tests. Patients with baseline cardiac dysautonomia showed no change in dysautonomia scores at the end of one year. Conclusion Our study showed that majority of patients who did not exhibit cardiac dysautonomia initially had developed this abnormality at the end of one year of chronic hemodialysis. Results Out of total fifty patients, 88% had dysautonomia at baseline. Of remaining six .

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