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ORIGINAL RESEARCH article

Front. Med.
Sec. Nephrology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1514214

Diagnostic Accuracy of Bellavere's Score in Cardiac Autonomic Neuropathy Among Chronic Kidney Disease Patients: A Study of Prevalence and Dialysis Impact

Provisionally accepted
Saket Satyasham Toshniwal Saket Satyasham Toshniwal *Sunil Kumar Sunil Kumar Sourya Acharya Sourya Acharya Abhishek Ghali Abhishek Ghali Sarang Raut Sarang Raut Vinit Deolikar Vinit Deolikar Harshitha Reddy Harshitha Reddy Palash Kotak Palash Kotak Anil Wanjari Anil Wanjari Shilpa Gaidhane Shilpa Gaidhane
  • General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India

The final, formatted version of the article will be published soon.

    Background: Cardiac autonomic neuropathy (CAN) is a significant complication in chronic kidney disease (CKD), leading to increased morbidity and mortality. Early detection is essential for managing CKD patients effectively, especially those on hemodialysis. This study evaluated the prevalence CAN in CKD and diagnostic accuracy of Bellavere's Score in predicting CAN in CKD patients, including those undergoing hemodialysis.Methods: This prospective observational study included 200 CKD patients. Cardiac autonomic neuropathy was assessed using Bellavere's Score, calculated through a series of autonomic function tests including heart rate variability and blood pressure responses.Bellavere's Score was measured pre-and post-dialysis in hemodialysis patients. The diagnostic performance of the score was evaluated using receiver operating characteristic (ROC) curves to determine sensitivity, specificity, and likelihood ratios.Results: Among the patients, 60% were diagnosed with CAN, with 35% having early CAN and 24% severe CAN. Bellavere's Score showed high diagnostic accuracy across CKD stages, with sensitivity ranging from 75% to 89.29% and specificity from 69.09% to 96%. In CKD stage III patients, the sensitivity was 78.57% and specificity 91.4%. In stage V, sensitivity increased to 89.29%, though specificity dropped to 69.09%. For hemodialysis patients, Bellavere's Score exhibited a sensitivity of 79.78% and specificity of 79.28%. The prevalence of CAN decreased significantly from 79.8% pre-dialysis to 64% post-dialysis (p < 0.01).Bellavere's Score provides a reliable and non-invasive approach for diagnosing CAN in CKD patients, with strong diagnostic performance across different disease stages and in hemodialysis. Larger studies are warranted to further validate its utility.

    Keywords: Bellavere's score, cardiac autonomic neuropathy, Chronic kidney disease (CKD), Dialysis, End stage renal disease

    Received: 20 Oct 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Toshniwal, Kumar, Acharya, Ghali, Raut, Deolikar, Reddy, Kotak, Wanjari and Gaidhane. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Saket Satyasham Toshniwal, General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.