Yang L, Zhao Y, Qiao B, et al. - Researchers sought to determine whether reduced heart rate variability (HRV) can serve as an independent predictor of death in maintenance hemodialysis patients. For this purpose, cohort studies describing the link between HRV and prognosis in hemodialysis patients were identified from Pubmed/Medline, EMBASE, Ovid, the Web of Science, and the Cochrane Central Register of Controlled Trials databases. In total, 7 eligible studies were analyzed. HRV metrics comprised SDNN, SDANN, RMSSD, pNN50, HRVTI, ULF, VLF, LF, HF, LF/HF ratio, HRT, DC, and scaling exponents α1 and α2. Findings revealed a higher risk of all-cause and cardiovascular death in correlation with the presence of decreased HRV in hemodialysis patients. Both all-cause and cardiovascular mortality were predicted by reduced SDANN and LF/HF, while the utility of other HRV metrics needs further inquiry.