Higher Resting Heart Rate Linked to Increased Mortality in Non-Dialysis-Dependent CKD Patients: Study Reveals

Japan: A study published in Scientific Reports found that an elevated heart rate is linked to a heightened mortality risk and cardiovascular events in patients with non-dialysis-dependent CKD. 

An increased heart rate is acknowledged as an independent risk factor for all-cause mortality and cardiovascular events in the general population. However, the link between elevated heart rate and adverse clinical outcomes in patients with non-dialysis-dependent chronic kidney disease (CKD) has not been thoroughly explored.

In this study, 1,353 participants from the Fukushima CKD Cohort Study, conducted by Hirotaka Saito and colleagues from the Department of Nephrology and Hypertension at Fukushima Medical University, were analyzed to examine the relationship between resting heart rate and clinical adverse outcomes using Cox proportional hazards analysis.

The key findings of the study are as follows:

• A higher resting heart rate in patients with non-dialysis-dependent CKD was associated with an increased risk of all-cause mortality.
• Participants with a resting heart rate of 80-89/min had a 1.74 times higher risk of mortality compared to those with a heart rate below 70/min.
• Those with a heart rate of 90/min or higher had a 2.61 times higher risk of mortality compared to the reference group.
• The group with a heart rate of 80-89/min also showed a significantly higher risk of cardiovascular events.
• However, the increased risk of cardiovascular events was not statistically significant in the group with a heart rate of 90/min or higher.

In summary, the findings of this study indicated that a higher resting heart rate is linked to all-cause mortality and cardiovascular events in patients with non-dialysis-dependent CKD. Future interventional studies are needed to determine whether lowering heart rate in CKD patients could improve clinical outcomes. It is important to recognize that, although various studies have observed associations between elevated heart rate and adverse clinical outcomes, the relationship between heart rate and mortality is complex. Age, comorbidities, and overall cardiovascular health significantly influence an individual's risk profile. Therefore, heart rate management should be personalized, with treatment decisions based on a comprehensive patient's overall health evaluation.

Reference

Saito, H., Tanaka, K., Ejiri, H. et al. Elevated resting heart rate is associated with mortality in patients with chronic kidney disease. Sci Rep 14, 17372 (2024). https://doi.org/10.1038/s41598-024-67970-2