Related Experiment Videos
Autonomic nervous system in haemodialysis
A Bondia1, J M Tabernero, J F Macias
1Hospital Clinico Universitario, Nephrology Service, Salamanca, Spain.
Summary
Patients with chronic renal failure undergoing hemodialysis often have autonomic neuropathy. This study found alterations in baroreceptors and sympathetic pathways, indicating significant autonomic dysfunction in these patients.
Area of Science:
- Nephrology
- Neurology
- Cardiology
Background:
- Autonomic neuropathy is a common complication in patients with chronic renal failure.
- Assessing autonomic function is crucial for managing these patients.
Purpose of the Study:
- To assess the existence and characteristics of autonomic neuropathy in patients with terminal chronic renal failure on hemodialysis.
- To identify the specific segments of the autonomic reflex arc affected.
Main Methods:
- Fifty-two patients on hemodialysis were evaluated for autonomic neuropathy using the Valsalva index.
- Eight healthy subjects and ten patients underwent cardiovascular autonomic function tests (phenylephrine, hyperventilation, cold pressor, atropine, tyramine, adrenaline).
Main Results:
- Patients on hemodialysis showed lower Valsalva index values compared to controls, indicating autonomic neuropathy.
- Autonomic testing revealed altered baroreceptor function, adrenergic hyperexcitability, and enhanced response to stimuli for extra-adrenal adrenaline release.
- A reduced response to atropine suggested vagal nerve alteration.
Conclusions:
- Patients with terminal chronic renal failure on hemodialysis exhibit significant autonomic neuropathy.
- The autonomic dysfunction involves baroreceptor alterations, sympathetic efferent pathway hypersensitivity, and vagal nerve impairment.