Open AccessStudy of Autonomic Neuropathy in Cardiovascular System in Chronic Renal Failure Patients on Maintenance Hemodialysis
Author(s) -
Darshan Ruparelia,
Ganpat Devpura,
Rakesh Thakuriya,
Bindu Rani
Publication year - 2022
Publication title -
east african scholars journal of medical sciences
Language(s) - English
Resource type - Journals
eISSN - 2617-7188
pISSN - 2617-4421
DOI - 10.36349/easms.2022.v05i02.002
Subject(s) - medicine , blood pressure , heart rate , hemodialysis , pure autonomic failure , autonomic nervous system , valsalva maneuver , cardiology , heart failure , reflex , autonomic neuropathy , anesthesia , biology , orthostatic vital signs , genetics , cell culture , neuroblastoma
Autonomic nervous system abnormalities are major causes of morbidity and mortality in patients with chronic renal failure (CRF) on hemodialysis and are generally considered a part of polyneuropathy. Postural hypotension, impotency, gastrointestinal disturbance, gastrointestinal motility, and sweating abnormalities are common symptoms. The most frequent complication in patients with CRF on hemodialysis is intradialytic hypotension, and it has been suggested that intradialytic hypotension is mostly related to autonomic neuropathy. The pathogenesis of autonomic neuropathy is unclear, but a reduced response to norepinephrine by the end organ and the toxic effect of metabolic toxins are considered to be some of the causes. Five cardiovascular reflex tests are generally used to determine autonomic neuropathy: the heart rate reaction to the Valsalva Maneuver, the heart rate variability during deep breathing, the heart rate response to standing up, the blood pressure response to standing up, and the blood pressure response to hand grip exercise.