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Autonomic Dysfunctions in Chronic Renal Egilure; Effects of Dialytic Methods

Year 1990, Volume: 43 Issue: 1, 147 - 158, 31.03.1990

Gültekin Süleymanlar

Abstract

In this study, we investigated the distrubances of autonomic functions in chronic renal failure (CRF) and the effects of dialytic methods on these functions. Tests of parasympathetic system (Valsalva maneuver, deep breathing and atropine test) and sympathetic system. (ortostasis, handgrip and cold pressure) and various ophtalmologic autonomiç testis were performed in 10 healthy persons, 6 predialytic patients, 8 patients on continuous ambulatory dialysis (CAPD groups) and 7 patients on hemodialysis (HD groups). Although there was no significant difference among there groups İrom the standpoints of responses t0 Valsalva meneuver, heart rate
responses io deep breathing and atropine test were observed to be reduced in patients with CRF (predialytic or dialytic) (p<0.01). The results of tests of sympathetic system in predialytic, CAPD and HD patients were similar tO those normal subjects (p>0.05). There was no difference among these groups in the ophtalmologic tests (>0.05).This study showed that in CRF, parasympathetic functions were impaired, but sympathetic abnormalities were trivial and that dialytic methots didn't have a considerable influence on autonomic functions.

Keywords

chronic renal failure autonomic dysfunction dialysis methods

References

  • 1.Klahr S, Buerkert J, Purkerson ML : Role of diatary factors in the progression of chronic renal disease. Kidney Int. 1983; 24 : 579. i
  • 2.Raskin NH, Fisman RA : Neurologic disorders in renal failure, N. Eng, J. Med. 1978; 294 : 143, 2D4 - 10.
  • 3.Fraser CL, Arieff Al ; Nervous system complications in uremia, Ann. Intern, Med. 1988; 109 : 143.
  • 4.Teschan PE, Ginn HE, Bourne JR, et al : Ouantitative indices of clinical uremia. Kidney Int. 1979; 15 : 676.
  • 5.Said G, Boudier L, Selva J, Zingraff J. Druekke T ; Different patterns of uremic polynephropathy : a cinicopathologic study. Neurology 1983; 33 : 567,
  • 6.English A, Savage RD, Britton PG, Ward MK, Kerr DNS ; Mmtellectual impairment in chronic renal failure. Br. Med. J. 1978; 1 : 888,
  • 7.Campase VM, Romoff MS, Levitan D, Lane K, Massry SG : Mechanisms of autonomic nervous system disfunction in uremia. Kidney Int. 1981; 20 : 246,
  • 8.Tyler HR : Neurological aspects of uremia : An overview. Kidney Int. 1978; (Suppl. 2) : 55; 188.
  • 9.Kersh ES, Kronfield SJ, Unger A, Popper RW, Cantor I, Cohn K. : Autonomic insufficiency in uremia as a cause hemodialysis induced hypotension, N, Engl, J. Med. 1974; 290 650,
  • 10.Mallamaci F, Zoccali C, Ciccarelli M, Briggs JD : Autonomic function in uremic patients treated by hemodialysis or CAPD and in transplant patients. Clin. Nephrol. 1986; 25 :
  • 175. 11.Solders G, Persson A, Wilczek H. Autonomic system dysfunction and polyneuropathy in nondiabetic uremic, Transplantation, 1986; 41 ; 616.
  • 12.Heidbreder E, Schafferhans K, Heinland A : Distrubances of peripheral and autonomic nervous system in chronic renal failure : effects of hemodialysis and
  • transplantation. Clin, Nephrol, 1985; 23 ; 222. 13.Levin AB : A simple test of cardiac function based upon heart rate changes induced by the Valsalva maneuer. Am. J. Cardial. 1966; 18 : 90.
  • 14.Lilley JJ, Golden J, Stone R : Adrenergic regulation of blood pressure in chronic renal failure, J. Clin. Invest. 1976; 57 ; 1190.
  • 15.Masey DN : Tests ol autonomic function. Lancet 1981; 1 : 46,
  • 16.Naik RB, Mathras CJ, Wilson CA, Reid JL, Warren DJ ; Cardiovascular and autonomiç neflexes in hemodialysis patients. Clin. Sci. 1981; 60 : 165.
  • 17.Hennessey WJ, Siemens AW : Autonomic neuropathy in chronic renal failure, Ci. Res. 1968; 16 : 3B5,
  • 18.Fraser CL, Ariff AI ; Nervous system manifestations of renal failure; In : Schrier RW, Gottschalk CW, eds. Disease of the Kidney, 4th ed. Boston ,Litte, Brown,
  • and Co, 1988; 3063-92, N
  • 19.Hilsted J. : Testing for autonomic neuropathy. Ann. Clin, Res. 1984; 16 ; 128.
  • 20.Pickering TG, Gribhbin B, Oliver DO : Baroreflex sensitivity in patients on long term hemodialysis, Clin. Sci, 1972; 43 : 645.
  • 21.Zoccali C, Cicarelli M, Maggiore © : Defective reflex control of heart rate in dialysis patjents evjdence for an afferent autonomic lesion, Clin, Sci, 1982; 63 : 285,
  • 22.Oreopoulos DG, Robson M, Faller B, Ogilvie R, Rappoport A, De Veber GA ; Continous ambulatory peritoneal dialysis, a new ere in the treatment of chronic renal failure, Clin. Nephrol, 1979; 11 : 125, .
  • 23.Nolph KD, Sorkin M, Robin J, Arfania D, Promentz B, Fruto L, Kennedy D ; Continous ambulatory peritoneal dialysis : Three-year experience at one center, Ann. Intern, Med. 1980; 92 : 608.
  • 24.Zoccali C, Cicarelli M, Mallamaci FE, Magsicre O : Parasympathetic function in hemodialysis patients. Nephron 1986; 44 : 351
  • 25.Goldberger S, Thompson A, Guha A, Kramer N, Parrish A : Autonomic nervous dysfunction in chronic renal failure. Clin. Res. 1971; 19 : 531. i Malik 5, Winey RJ, Ewing DJ :
  • 26.Chronic renal failure and cardiovascular autonomic function. Nephron 1986; 43 : 191.
  • 27.Henrich WL : Autonomic İnsufliciency, Arch. Intern. Med. 1982; 149 ; 339.

Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi

Year 1990, Volume: 43 Issue: 1, 147 - 158, 31.03.1990

Gültekin Süleymanlar

Abstract

Bu çalışmada, kronik böbrek yetmezlikli hastalarda otonomik fonksiyon bozuklukları ile diyaliz yöntemlerinin bu fonksiyonlar üzerine etkisi incelendi. Çalışmada 10'u sağlıklı kontrol, 6'sı predialitik, 8'i periton diyalizi (CAPD) ve 7'si hemodiyaliz (HD) tedavisi gören toplam 21 kronik böbrek yetmezliği hastasında parasempatik (Valsalva manevrası, derin nefes alma ve atropin testleri) ve sempatik (ortostasis, handgrip ve cold pressure) testleri ile çeşitli oftalmik otonomik testler uygulandı. Gruplar arasında Valsalva testine cevaplar farksız bulunurken (p>0.05), derin nefes alma ve atropin testlerine kalb hızı cevaplarının kronik böbrek yetmezlikli hastalarda (diyaliz
görsün veya görmesin) azaldığı gözlendi (p<0.01). Prediyaliz, CAPD ve HD gruplarındaki sempatik testlerde (kan basıncı değişikliğine dayanan testlerde) normal kontrollerdekine benzer sonuçlar alındı (p>0.05) , Oftalmik otonomik testler açısından gruplar arasında farklıık bulunmadı (p>0.05). Çalışmamızda kronik böbrek yetmezlikli hastalarda parasempatik fonksiyonların bozulmasına karşın sempatik tutulumun önemsiz olduğu ve ayrıca diyaliz yöntemlerinin otonomik fonksiyonlar üzerine anlamlı etkisi olmadığı sonucuna varıldı.

Keywords

kronik böbrek yetmezliği otonomik fonksiyon bozuklukları diyaliz yöntemlerin

References

  • 1.Klahr S, Buerkert J, Purkerson ML : Role of diatary factors in the progression of chronic renal disease. Kidney Int. 1983; 24 : 579. i
  • 2.Raskin NH, Fisman RA : Neurologic disorders in renal failure, N. Eng, J. Med. 1978; 294 : 143, 2D4 - 10.
  • 3.Fraser CL, Arieff Al ; Nervous system complications in uremia, Ann. Intern, Med. 1988; 109 : 143.
  • 4.Teschan PE, Ginn HE, Bourne JR, et al : Ouantitative indices of clinical uremia. Kidney Int. 1979; 15 : 676.
  • 5.Said G, Boudier L, Selva J, Zingraff J. Druekke T ; Different patterns of uremic polynephropathy : a cinicopathologic study. Neurology 1983; 33 : 567,
  • 6.English A, Savage RD, Britton PG, Ward MK, Kerr DNS ; Mmtellectual impairment in chronic renal failure. Br. Med. J. 1978; 1 : 888,
  • 7.Campase VM, Romoff MS, Levitan D, Lane K, Massry SG : Mechanisms of autonomic nervous system disfunction in uremia. Kidney Int. 1981; 20 : 246,
  • 8.Tyler HR : Neurological aspects of uremia : An overview. Kidney Int. 1978; (Suppl. 2) : 55; 188.
  • 9.Kersh ES, Kronfield SJ, Unger A, Popper RW, Cantor I, Cohn K. : Autonomic insufficiency in uremia as a cause hemodialysis induced hypotension, N, Engl, J. Med. 1974; 290 650,
  • 10.Mallamaci F, Zoccali C, Ciccarelli M, Briggs JD : Autonomic function in uremic patients treated by hemodialysis or CAPD and in transplant patients. Clin. Nephrol. 1986; 25 :
  • 175. 11.Solders G, Persson A, Wilczek H. Autonomic system dysfunction and polyneuropathy in nondiabetic uremic, Transplantation, 1986; 41 ; 616.
  • 12.Heidbreder E, Schafferhans K, Heinland A : Distrubances of peripheral and autonomic nervous system in chronic renal failure : effects of hemodialysis and
  • transplantation. Clin, Nephrol, 1985; 23 ; 222. 13.Levin AB : A simple test of cardiac function based upon heart rate changes induced by the Valsalva maneuer. Am. J. Cardial. 1966; 18 : 90.
  • 14.Lilley JJ, Golden J, Stone R : Adrenergic regulation of blood pressure in chronic renal failure, J. Clin. Invest. 1976; 57 ; 1190.
  • 15.Masey DN : Tests ol autonomic function. Lancet 1981; 1 : 46,
  • 16.Naik RB, Mathras CJ, Wilson CA, Reid JL, Warren DJ ; Cardiovascular and autonomiç neflexes in hemodialysis patients. Clin. Sci. 1981; 60 : 165.
  • 17.Hennessey WJ, Siemens AW : Autonomic neuropathy in chronic renal failure, Ci. Res. 1968; 16 : 3B5,
  • 18.Fraser CL, Ariff AI ; Nervous system manifestations of renal failure; In : Schrier RW, Gottschalk CW, eds. Disease of the Kidney, 4th ed. Boston ,Litte, Brown,
  • and Co, 1988; 3063-92, N
  • 19.Hilsted J. : Testing for autonomic neuropathy. Ann. Clin, Res. 1984; 16 ; 128.
  • 20.Pickering TG, Gribhbin B, Oliver DO : Baroreflex sensitivity in patients on long term hemodialysis, Clin. Sci, 1972; 43 : 645.
  • 21.Zoccali C, Cicarelli M, Maggiore © : Defective reflex control of heart rate in dialysis patjents evjdence for an afferent autonomic lesion, Clin, Sci, 1982; 63 : 285,
  • 22.Oreopoulos DG, Robson M, Faller B, Ogilvie R, Rappoport A, De Veber GA ; Continous ambulatory peritoneal dialysis, a new ere in the treatment of chronic renal failure, Clin. Nephrol, 1979; 11 : 125, .
  • 23.Nolph KD, Sorkin M, Robin J, Arfania D, Promentz B, Fruto L, Kennedy D ; Continous ambulatory peritoneal dialysis : Three-year experience at one center, Ann. Intern, Med. 1980; 92 : 608.
  • 24.Zoccali C, Cicarelli M, Mallamaci FE, Magsicre O : Parasympathetic function in hemodialysis patients. Nephron 1986; 44 : 351
  • 25.Goldberger S, Thompson A, Guha A, Kramer N, Parrish A : Autonomic nervous dysfunction in chronic renal failure. Clin. Res. 1971; 19 : 531. i Malik 5, Winey RJ, Ewing DJ :
  • 26.Chronic renal failure and cardiovascular autonomic function. Nephron 1986; 43 : 191.
  • 27.Henrich WL : Autonomic İnsufliciency, Arch. Intern. Med. 1982; 149 ; 339.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Nefroloji
Journal Section Articles
Authors

Gültekin Süleymanlar

Publication Date March 31, 1990
Published in Issue Year 1990 Volume: 43 Issue: 1

Cite

APA Süleymanlar, G. (1990). Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 43(1), 147-158.
AMA Süleymanlar G. Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. March 1990;43(1):147-158.
Chicago Süleymanlar, Gültekin. “Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon Ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 43, no. 1 (March 1990): 147-58.
EndNote Süleymanlar G (March 1, 1990) Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası 43 1 147–158.
IEEE G. Süleymanlar, “Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 43, no. 1, pp. 147–158, 1990.
ISNAD Süleymanlar, Gültekin. “Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon Ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 43/1 (March 1990), 147-158.
JAMA Süleymanlar G. Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1990;43:147–158.
MLA Süleymanlar, Gültekin. “Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon Ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 43, no. 1, 1990, pp. 147-58.
Vancouver Süleymanlar G. Kronik Böbrek Yetmezliğinde Otonomik Disfonksiyon ve Diyaliz Yöntemlerinin Bunlara Olan Etkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1990;43(1):147-58.
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