Key result
CAPD patients maintain adequate blood pressure regulation in ~72% of cases despite significant autonomic dysfunction.
Why the study?
The role of autonomic nervous system dysfunction in arterial blood pressure regulation in uremic patients treated by continuous ambulatory peritoneal dialysis was unclear.
What is the role of autonomic nervous system dysfunction in blood pressure regulation in uremic patients on CAPD?
Cross-Sectional (n=14)
What is the role of autonomic nervous system dysfunction in blood pressure regulation in uremic patients on CAPD?
In uremic patients on CAPD, blood pressure regulation remains adequate despite significant autonomic nervous system dysfunction, suggesting other factors play a greater role.
BP regulation remains adequate in most CAPD patients despite autonomic dysfunction; leaves open dominant regulatory mechanisms and requires prospective studies.
The role of autonomic nervous system dysfunction In the regulation of arterial blood pressure In 4 male and 10 female uremic patients, age 35–65 years (57±9 years), treated by continuous ambulatory peritoneal dialysis (CAPO) for 6–40 months (20±12 months), was studied. The integrity of the entire autonomic reflex arc was checked using Valsalva's test and the orthostasis challenge test in parallel, efferent sympathetic function was tested with the handgrip test. A significantly decreased Valsalva ratio was found In 7 patients (50%), and it was normal in only 2 patients (14%). The handgrip test was subnormal in 5 patients (36%) and abnormal In 7 patients (50%). On the contrary, the orthostatic challenge test showed normal compensatory reaction in 10 patients (72%). The evaluation of three autonomic tests showed combined (afferent + efferent) lesion In 6 patients (43%), predominant afferent lesion In 3 patients (21 %), and In 3 patients predominant efferent lesion. In 2 patients (14%) there was no end-organ response. Despite significant autonomic nervous system dysfunction In uremics on CAPO, as demonstrated by these results, blood pressure regulation In the supine and up right position was adequate In most patients (72%), indicating a relatively greater role of other blood pressure-regulating factors.
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Janković et al. (1993) conducted a cross-sectional in Uremia (n=14). Continuous ambulatory peritoneal dialysis (CAPD) was evaluated on Autonomic reflex arc integrity and blood pressure regulation. Despite significant autonomic nervous system dysfunction in uremic patients on CAPD, blood pressure regulation was adequate in 72% of patients.
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