[Cardiovascular reflex evaluation for detecting autonomic neuropathy in chronic dialysis patients]

3 cardiovascular reflexes were tested in 25 patients on regular haemodialysis: measurement of the beat-to-beat variation in heart rate in the supine position and during deep breathing, measurement of heart rate response to change in posture (30:15 ratio). 8 patients (32%) had abnormal results in at least two of the tests, 3 patients (12%) had abnormal results in all 3 tests. Beat-to-beat variation was found to be the most sensitive test, the heart rate difference during deep breathing showing a direct correlation to the nerve conduction velocity of the peroneal nerve. Hence, a common cause can be postulated in the pathogenesis of the autonomic lesions and the sensorimotor polyneuropathy in the patients under investigation. Furthermore, the group with the most severe radiological calcification due to Mönckeberg's medial sclerosis had a significantly lower mean heart rate difference during deep breathing than the group with no radiological calcification. A similar correlation between autonomic neuropathy and Mönckeberg's medial sclerosis has recently been described in diabetic patients.