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Updated: Dec 9, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Autonomic dysfunction in kidney diseases.

S Lai1, D Bagordo, A M Perrotta

  • 1Department of Translational and Precision Medicine, Nephrology Unit, Sapienza University of Rome, Rome, Italy. silvia.lai@uniroma1.it.

European Review for Medical and Pharmacological Sciences
|September 7, 2020
PubMed
Summary
This summary is machine-generated.

Kidney disease disrupts the balance between sympathetic and parasympathetic nervous systems, increasing cardiovascular risks. Assessing these autonomic functions is crucial for managing end-stage renal disease (ESRD) patients.

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Area of Science:

  • Nephrology
  • Cardiology
  • Autonomic Neuroscience

Background:

  • Kidney diseases present numerous cardiovascular risks, including anemia, inflammation, and fluid overload.
  • End-stage renal disease (ESRD) patients commonly exhibit altered sympathovagal balance, with sympathetic hyperactivity linked to increased heart rate, myocardial hypertrophy, and fibrosis.
  • These cardiac changes elevate the risk of sudden cardiac death due to fatal arrhythmias.

Purpose of the Study:

  • To review the intricate relationship between sympathovagal disturbances and kidney disease.
  • To explore the impact of renal replacement therapies and transplantation on autonomic function.
  • To highlight the clinical relevance of assessing sympathetic and parasympathetic tones in ESRD.

Main Methods:

  • Review of current literature on autonomic nervous system function in kidney disease.
  • Analysis of heart rate variability and other indices for evaluating sympathovagal balance.
  • Synthesis of data concerning cardiovascular risk factors in ESRD.

Main Results:

  • Sympathetic hyperactivity and parasympathetic withdrawal are prevalent in ESRD.
  • Autonomic dysfunction contributes significantly to cardiovascular morbidity and mortality in kidney disease patients.
  • Heart rate variability metrics show potential as diagnostic tools for clinical decision-making.

Conclusions:

  • Dysregulation of the sympathovagal balance is a critical factor in the cardiovascular complications of kidney disease.
  • Monitoring autonomic function can aid in risk stratification and therapeutic strategy development for ESRD patients.
  • Further research into autonomic assessment tools may improve patient outcomes in renal disease and post-transplant settings.