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Autonomic function in hemodialyzed patients.

A Zuccalà, E D Esposti, A Sturani

    The International Journal of Artificial Organs
    |March 1, 1978
    PubMed
    Summary
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    Autonomic function in hemodialysis patients revealed normal sympathetic responses but abnormal Valsalva maneuver results in many. This suggests potential vagal control or cardiac performance issues in uremic individuals.

    Area of Science:

    • Nephrology
    • Cardiology
    • Autonomic Neuroscience

    Background:

    • Chronic kidney disease patients undergoing regular hemodialysis often exhibit complications.
    • Autonomic dysfunction is a recognized concern in uremic patients.
    • Non-invasive assessment of autonomic function is crucial for understanding patient health.

    Purpose of the Study:

    • To evaluate autonomic nervous system function in patients on maintenance hemodialysis.
    • To compare autonomic responses between hemodialyzed patients and healthy controls.
    • To identify specific areas of autonomic dysfunction in uremic individuals.

    Main Methods:

    • Utilized simple, non-invasive, repeatable techniques to assess autonomic function.
    • Included Valsalva maneuver, cold pressor test, mental stress test, tilt test, and diving reflex test.

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  • Measured systolic-time intervals and plasma catecholamines levels in all participants.

    • Main Results:

    • Hemodialysis patients showed normal responses to cold pressor, mental stress, and tilt tests, with normal plasma catecholamines.
    • 17 out of 34 hemodialyzed patients exhibited an abnormal Valsalva maneuver ratio (<1.40).
    • Abnormal Valsalva responses correlated with alterations in the diving reflex and/or pathological systolic-time intervals.

    Conclusions:

    • Sympathetic nervous system function appears preserved in regular hemodialyzed patients.
    • Abnormal Valsalva maneuver responses likely indicate impaired vagal control of the heart or altered cardiac performance.
    • Further investigation into cardiac autonomic regulation is warranted for hemodialysis patients.