Autonomic dysregulation in patients awaiting kidney transplantation

Dk, Hathaway; Cashion, AK; Milstead, E. Jean; Rp, Winsett; Cowan, Patricia A.; Wicks, Mona; Gaber, A. Osama

doi:10.1053/ajkd.1998.v32.pm9708605

Cited by 80 publications

(57 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the signal-processing technique employed here allows us to study the non-respiratory derived components of autonomic dysfunction, which we suspect may be important in the fundamental pathology of SCA. Given that otherwise unexplained sudden death accounts for up to 40% of the mortality in SCA and that autonomic dysregulation has clearly been associated with sudden death in other settings (Hathaway et al 1998, Sathyaprabha et al 2006, Piepoli and Capucci 2007, the application of the experimental and analytical methodology introduced in the current study may yield important insights into the pathophysiology and perhaps the clinical management of sickle cell disease. Representative time courses of oxygen saturation (SaO 2 ), R-wave to R-wave interval (RRI), and minute ventilation (vent) from a sickle cell anemia patient (SCA) and a normal control subject (CON) after transient episode of hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia

2008

View full text Add to dashboard Cite

The objective of this study was to non-invasively assess cardiac autonomic control in subjects with sickle cell anemia (SCA) by tracking the changes in heart rate variability (HRV) that occur following brief exposure to a hypoxic stimulus. Five African-American SCA patients and seven healthy control subjects were recruited to participate in this study. Each subject was exposed to a controlled hypoxic stimulus consisting of five breaths of nitrogen. Time-varying spectral analysis of HRV was applied to estimate the cardiac autonomic response to the transient episode of hypoxia. The confounding effects of changes in respiration on the HRV spectral indices were reduced by using a computational model. A significant decrease in the parameters related to parasympathetic control was detected in the post-hypoxic responses of the SCA subjects relative to normal controls. The spectral index related to sympathetic activity, on the other hand, showed a tendency to increase the following hypoxic stimulation, but the change was not significant. This study suggests that there is some degree of cardiovascular autonomic dysfunction in SCA that is revealed by the response to transient hypoxia.

show abstract

Section: Discussionmentioning

confidence: 99%

Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia

2008

View full text Add to dashboard Cite

show abstract

“…PT is most frequently performed in type 1 diabetic patients in advanced stages of diabetic nephropathy and with other microvascular complications. Diabetic neuropathy, involving motor, sensory and autonomic nerves to a similar extent, is very common and severe in these patients [35,36].…”

Section: Clinical Datamentioning

confidence: 98%

Advanced Diabetic Neuropathy: A Point of no Return?

Bouc̆ek¹

2006

Rev Diabetic Stud

View full text Add to dashboard Cite

■ AbstractDiabetic peripheral neuropathy is the most common complication of long-standing diabetes mellitus which frequently results in clinically significant morbidities e.g. pain, foot ulcers and amputations. During its natural course it progresses from initial functional changes to late, poorly reversible, structural changes. Various interconnected pathogenetic concepts of diabetic neuropathy have been proposed based on metabolic and vascular factors, mostly derived from long-term hyperglycemia. These pathogenetic mechanisms have been targeted in several experimental and clinical trials. This review summarizes available, mainly morphological data from interventions designed to halt the progression or achieve the reversal of established diabetic neuropathy, which include the recovery of normoglycemia by pancreas or islet transplantation, polyol pathway blockade by aldose reductase inhibitors, mitigation of oxidative stress by the use of antioxidants or correction of abnormalities in essential fatty acid metabolism. Unfortunately, to date, no treatment based on pathogenic considerations has shown clear positive effects and thus early institution of optimal glycemic control remains the only available measure with proven efficacy in preventing or halting progression of diabetic neuropathy. Further experimental and clinical research employing objective reproducible parameters is clearly needed. Novel noninvasive or minimally invasive methods e.g. corneal confocal microscopy or epidermal nerve fiber counts may represent potentially useful instruments for the objective assessment of nerve damage and monitoring of treatment effects.

show abstract

“…25,26 However, other groups have reported reduced HF, increased LF, and LF/HF in HD patients. 27 Indeed, Giordano et al 27 have suggested that this increased sympathetic activity may predispose to sudden cardiac death in waiting list renal transplant patients.…”

Section: Discussionmentioning

confidence: 99%

The Study of Spectral Analysis of Heart Rate Variability in Different Blood Pressure Types in Euvolemic Peritoneal Dialysis Patients

Perucho

Tang

et al. 2012

Renal Failure

View full text Add to dashboard Cite

Background: Heart rate variability (HRV) is an useful noninvasive tool to assess autonomic nervous system (ANS) function and may provide an insight into the understanding of the role of ANS in the pathogenesis of blood pressure (BP) abnormality in euvolemic continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: In this cross-sectional study, 62 CAPD patients with normal hydration values (assessed by a bioimpedance spectroscopy device) were enrolled from our peritoneal dialysis (PD) unit. Patients were divided into three groups according to their BP: normotension (NT), hypertension (HT), and hypotension (HyT). Spectral analysis of HRV was measured by examination of the average heart rate using standard electrocardiogram in 5 min. Results: The HyT group had the lowest serum urea nitrogen among the three groups (all p < 0.05), and a lower serum potassium and albumin as compared with the NT group (p < 0.05). The HyT group also had the highest total power (TP) and highest frequency power (HF) among the three groups (all p < 0.05), and a lower normalized low frequency power (LF), LF/HF ratio, and a higher normalized HF as compared with the HT group (all p < 0.05). Conclusion: Our study suggested that autonomic insufficiency was present in euvolemic PD patients, and hypotensives had a relatively higher parasympathetic activity and blunted sympathetic activity.

show abstract

Autonomic dysregulation in patients awaiting kidney transplantation

Cited by 80 publications

References 41 publications

Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia

Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia

Advanced Diabetic Neuropathy: A Point of no Return?

The Study of Spectral Analysis of Heart Rate Variability in Different Blood Pressure Types in Euvolemic Peritoneal Dialysis Patients

Contact Info

Product

Resources

About