Increased Heart Rate Found to Be Associated With Kidney Function Declines in Transplant Recipients

Increased heart rate was found to be associated with a faster reduction in the ability for the kidneys to filter out toxins in patients who have undergone a kidney transplant, according to results presented at the 2021 American Heart Association Scientific Sessions.

The results of the single-center retrospective cohort study showed a significant association between heart rate and estimated glomerular filtration rate (eGFR), finding that heart rate can play a role in declining kidney function in transplant recipients specifically.

Heart rate has been shown to be a biomarker for the sympathetic nervous system, and evidence has established that it has an association with kidney function levels among the general population.

Using a multiple linear regression analysis, the investigators examined the connection between average heart rate across 4 office visits at 12, 24, 36, and 48 weeks after receiving a kidney transplant and the rate of eGFR decline between 12 and 48 weeks post transplant. Retrospective data for a cohort of 105 recipients of kidney transplants with a mean (SD) age of 54.33 (11.60), 61% of whom were women, were analyzed.

The mean (SD) eGFR was 57.23 (1.74) mL/min/1.73 m² at 12 weeks and 60.58 (1.89) mL/min/1.73 m² at 48 weeks, representing an increase in mean (SD) eGFR of 3.35 (1.43) mL/min/1.73 m² (P = .0211). The median rate of eGFR change was 4.31 mL/min/1.73 m² per year (interquartile range, –5.75 to 15.39).

Every 1 beat per minute increase in heart rate was found to be associated with a 0.3 mL/min/1.73 m² annual decrease in eGFR (95% CI, –0.645 to 0.051; P = .093) and 1.01 times higher odds of rapid change in eGFR (odds ratio, 1.007; 95% CI, 0.973-1.045; P = .662).

After the investigators adjusted for age, gender, transplant type, and induction immunosuppression, an increase in 1 beat per minute of heart rate was revealed to be associated with 0.39 mL/min/1.73 m² annual decline in eGFR (95% CI, –0.746 to –0.025; P = .036).

The researchers said that future studies are still needed to elucidate underlying mechanisms by considering both immunological and nonimmunological factors.

Reference

Tantisattamo E, Mutirangura P, Polpichai N, Saowapa S, Eguchi N. Heart rate and estimated glomerular filtration rate decline in kidney transplant recipients. Presented at: 2021 American Heart Association Scientific Sessions; November 14, 2021. Abstract P2001.