PARATHYROIDECTOMY IS ASSOCIATED WITH REVERSED NON-DIPPING HEART RATE WHICH IMPACT ON MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS.

ABSTRACT Objective Non-dipping heart rate (HR), defined as night/day HR>0.90, was associated with increased mortality in epidemiological studies. However, its prognostic value in stage 5 chronic kidney disease (CKD5) patients and the effects of parathyroidectomy (PTX) on non-dipping HR remain unknown. Methods This case-control study of 162 healthy controls and 502 CKD5 patients was performed between 2011 and 2018, in which CKD5 patients were further divided into non-PTX (n=186) and severe secondary hyperparathyroidism (SHPT) with PTX (n=316) subgroups. Each participant underwent 24-hour Holter for HR ratio. Mortality was followed up in CKD5 patients (median time: 46.0 months). Results HR ratio in CKD5 patients was higher than controls (0.92±0.08 vs 0.81±0.08, P 500.0 pg/ml). Conclusion CKD5 patients displayed non-dipping HR pattern which is a prognostic marker of all-cause mortality. PTX for SHPT patients was associated with reversal in non-dipping HR ratio which may mediate a better outcome.