Sudden cardiac death and atherosclerosis have a major impact on cardiovascular mortality in chronic kidney disease (CKD). Inflammation with elevated high-sensitive C-reactive protein (hs-CRP) is involved in both sudden cardiac death and atherosclerosis, and decreased heart rate variability (HRV) is a predictor of both sudden cardiac death and atherosclerosis. Haptoglobin (Hp) is characterised by three genotypes (1-1, 2-1, and 2-2) with different antioxidant abilities. The aim was to examine whether HRV and hs-CRP were associated with Hp genotype in CKD patients. Fifty-six patients with CKD stage 2–5 were included. Hp genotype was determined by high-performance liquid chromatography. HRV was analysed from the 24 h Holter recordings. Hs-CRP was measured using an immunoturbidimetric assay. The results show that the HRV indices SDNN and SDANN were significantly lower in the Hp 2-2 patients ( and 0.04, resp.). In an adjusted linear regression model, Hp 2-2 was associated with both SDNN ( ) and SDANN ( ). Hs-CRP was higher in the Hp 2-2 patients ( ). In an adjusted linear regression model, the association between Hp 2-2 and hs-CRP remained significant ( ). In conclusion, a negative association was observed between Hp 2-2 and HRV, and Hp 2-2 was positively associated with hs-CRP in CKD patients. 1. Introduction Cardiovascular disease (CVD) including sudden cardiac death (SCD) [1] is a major cause of mortality in chronic kidney disease (CKD) [2]. Apart from left ventricular dysfunction [1], unique factors such as autonomic imbalance and inflammation contribute to the high incidence of SCD in CKD [3]. Traditional risk factors for atherosclerosis [4], such as hypertension and dyslipidaemia, can to some extent explain the increased risk of atherosclerosis in CKD [5]. However, nontraditional risk factors like oxidative stress and inflammation may also be of importance [6]. Heart rate variability (HRV) is a reliable, noninvasive measurement of autonomic tone of the heart [7]. A reduction in HRV reflects an autonomic imbalance towards decreased vagal tone and subsequent sympathetic overactivity [3]. Decreased HRV is a predictor of SCD in patients with CKD [8]. Furthermore, attenuated HRV is associated with atherosclerosis in CKD [9]. Chronic, low-grade inflammation is involved in the development of both SCD [10] and atherosclerosis [11]. The most extensively examined marker of inflammation is high-sensitive C-reactive protein (hs-CRP), which is a predictor of cardiovascular mortality in different populations [12, 13] including patients with CKD [14]. Hs-CRP may even
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