Localization of autonomic nervous system dysfunction in dialysis patients.

Y. Nakashima, F. M. Fouad, S. Nakamoto, Stephen C Textor, E. L. Bravo, R. C. Tarazi

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Autonomic nervous system dysfunction has been described frequently in uremic patients. The purpose of this study is to determine the localization of this abnormality and to study the possible relationship between autonomic dysfunction and the occurrence of dialysis hypotension. Sixteen consecutive patients participated in the study, 5 of whom had a history of dialysis-induced hypotension. These 5 patients were compared to the other 11 as regards the cardiovascular response to isoproterenol infusion, tilt test and arteriovenous (AV) fistula occlusion. None of the responses to the above mentioned stimuli was significantly different between the 2 groups. In the whole study population, an index of parasympathetic control of heart rate (variation of heart period, VHP) was reduced (31 +/- 5 vs. 59 +/- 9 ms in age-matched controls; p less than 0.025). Heart rate and diastolic blood pressure response to isoproterenol infusion was normal (+23 +/- 2 beats/min and -9 +/- 3 mm Hg; p less than 0.005 for both), indicating normal response of effector organs to beta-adrenergic agonist stimulation. Similarly, plasma norepinephrine increased significantly (+294 +/- 51 pg/ml; p = NS from normal laboratory values) in response to head-up tilt, and heart rate increased simultaneously in all but 5 patients. Blood pressure response was within normal after 10 min of head-up tilt at 60 degrees in all but 3 patients; only 1 of these 3 patients was in the group of dialysis hypotension. However, during AV fistula occlusion, heart rate did not change markedly, despite the significant increase in systolic blood pressure, suggesting an altered sensitivity of baroreceptor reflex arc.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish (US)
Pages (from-to)375-381
Number of pages7
JournalAmerican Journal of Nephrology
Volume7
Issue number5
StatePublished - 1987
Externally publishedYes

Fingerprint

Autonomic Nervous System
Dialysis
Blood Pressure
Heart Rate
Arteriovenous Fistula
Isoproterenol
Hypotension
Head
Controlled Hypotension
Adrenergic beta-Agonists
Baroreflex
Norepinephrine
Reference Values
Population

ASJC Scopus subject areas

  • Nephrology

Cite this

Nakashima, Y., Fouad, F. M., Nakamoto, S., Textor, S. C., Bravo, E. L., & Tarazi, R. C. (1987). Localization of autonomic nervous system dysfunction in dialysis patients. American Journal of Nephrology, 7(5), 375-381.

Localization of autonomic nervous system dysfunction in dialysis patients. / Nakashima, Y.; Fouad, F. M.; Nakamoto, S.; Textor, Stephen C; Bravo, E. L.; Tarazi, R. C.

In: American Journal of Nephrology, Vol. 7, No. 5, 1987, p. 375-381.

Research output: Contribution to journalArticle

Nakashima, Y, Fouad, FM, Nakamoto, S, Textor, SC, Bravo, EL & Tarazi, RC 1987, 'Localization of autonomic nervous system dysfunction in dialysis patients.', American Journal of Nephrology, vol. 7, no. 5, pp. 375-381.
Nakashima Y, Fouad FM, Nakamoto S, Textor SC, Bravo EL, Tarazi RC. Localization of autonomic nervous system dysfunction in dialysis patients. American Journal of Nephrology. 1987;7(5):375-381.
Nakashima, Y. ; Fouad, F. M. ; Nakamoto, S. ; Textor, Stephen C ; Bravo, E. L. ; Tarazi, R. C. / Localization of autonomic nervous system dysfunction in dialysis patients. In: American Journal of Nephrology. 1987 ; Vol. 7, No. 5. pp. 375-381.
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