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Heart rate variability (HRV), a measure of autonomic function, is associated with mortality in non-end stage renal disease (ESRD). The purpose of this pilot study was to determine if HRV was predictive of mortality in patients on dialysis and to identify at-risk factors. Patients on chronic hemodialysis (n = 53) were assessed at baseline and again 24 months later. Baseline measures quantified 24-hour HRV, health, depression, and quality of life (QoL). Twenty-four-month data determined mortality. Participants were African American, 49% male, aged 47.8 ± 13.3 years, with 62.4 ± 60 months of dialysis. Outcomes of 24-hour HRV measures were impaired for all groups. Factors including exercise and smoking were associated with diminished HRV. The low frequency-high frequency ratio was found to be the most influential HRV determinant of death. The ability to identify patients at-risk for death and to prescribe therapy to reduce risk could have significance for the care of patients with ESRD.                                                                                      

Ann K. Cashion, PhD, RN, is Associate Professor, College of Nursing, University of Tennessee Health Science Center, Memphis, TN.

Sandra L. Holmes, MSN, APRN, BC, is Doctoral Student, College of Nursing, University of Tennessee Health Science Center, Memphis, TN.

Kristopher L. Arheart, PhD, is Research Scientist, School of Nursing, University of Texas, Austin, TX.

Sergio R. Acchiardo, MD, is Professor, College of Medicine, Department of Nephrology, University of Tennessee Health Science Center, Memphis, TN.

Donna K. Hathaway, PhD, RN, is Dean and Professor, College of Nursing, University of Tennessee Health Science Center, Memphis, TN.