Autonomic Nervous System Dysfunction and Impotence in Uremia

Campese, Vito M.; Procci, Warren R.; Levitan, Daniel; Romoff, Mark S.; Goldstein, David; Massry, Shaul G.

doi:10.1159/000166629

Cited by 41 publications

(17 citation statements)

References 1 publication

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“…Previous studies of the effect of dialysis on plasma noradrenaline levels have produced conflicting results [1,41]. The finding of elevated plasma noradrenaline levels at rest conflicts with previous obser vations [42], The absence of an effect of haemodialysis on plasma noradrenaline in the present study suggests that sympathetic nervous activity is not impaired as a conse quence of haemodialysis and that depletion of plasma noradrenaline is unlikely to be a contributory factor to haemodialysis-induced hypotension. Alternatively, the absence of a rise in plasma noradrenaline when extracel lular fluid volume had been reduced by haemodialysis may be a pointer to reduced sympathetic efferent activity.…”

Section: Discussioncontrasting

confidence: 93%

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

1985

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The mechanisms of hypotension during haemodialysis were investigated by studying cardiovascular reflexes, body fluid volumes, and osmolality in 11 patients with renal failure before and after haemodialysis and in 17 normal subjects before and after furosemide diuresis. Blood pressure and heart rate responses to tests of autonomic nervous function were unaffected in either group except that in the patients, head-up tilt after haemodialysis caused a fall in blood pressure. This was associated with a greater fall in cardiac output than before haemodialysis but with a similar rise in peripheral vascular resistance. Resting plasma noradrenaline levels were higher than normal, and the rise in plasma noradrenaline levels in response to tilt was unaffected by haemodialysis. Plasma renin activity rose in response to head-up tilt in normal subjects, but not in patients either before or after haemodialysis. Our studies indicate that changes in plasma potassium and osmolality or the possible peripheral circulatory effects of acetate do not impair the regulation of the circulation in response to haemodialysis. Haemodialysis does not reduce plasma noradrenaline levels. Impaired myocardial function in response to fluid depletion or unresponsiveness of the renin-angiotensin system may contribute to haemodialysis hypotension.

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Section: Discussioncontrasting

confidence: 93%

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

1985

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“…clinical disorders and normal renal function do not dis play evidence of ANS dysfunction [5]. It appears that anemia of CRF does not play a major role in the genesis of ANS dysfunction.…”

Section: Resultsmentioning

confidence: 88%

“…It appears that anemia of CRF does not play a major role in the genesis of ANS dysfunction. Campese et al [5] found no signif icant difference in the values of hematocrit of CRF and dialysis patients with and without ANS dysfunction. Our data also show that hematocrit values in dialysis patients with volume-responsive or volume-nonresponsive hypo tension were not significantly different.…”

Section: Resultsmentioning

confidence: 93%

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Autonomic Nervous System Dysfunction and Volume Nonresponsive Hypotension in Hemodialysis Patients

Stojceva-Taneva¹,

Masin²,

Polenakovič³

et al. 1991

Am J Nephrol

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Studies were conducted in 9 dialysis patients with volume-nonresponsive hypotension, 6 dialysis patients with volume-responsive hypotension and in 10 normal subjects in an effort to evaluate the role of dysfunction of the autonomic nervous system (ANS) in the genesis of volume-nonresponsive hypotension. ANS function was evaluated by the Valsalva maneuver, handgrip exercise, and by the response of heart rate and blood pressure to change of posture from a supine to a standing position. Patients with volume-nonresponsive hypotension displayed significant derangements in the function of ANS as compared to normal subjects and to patients with volume-responsive hypotension. Data show that dysfunction of ANS plays an important role in the genesis of volume-nonresponsive hypotension in dialysis patients.

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“…The simultaneous occurrence of pheochromo- To the authors' knowledge, determination of excretory end products of CA metabolism in the plasma of such patients has not been reported. Moreover, interpretation of plasma CA is impaired, as patients on long-term hemo dialysis (LTH) without pheochromocytoma already have an altered CA status as compared with a normal popula tion, and a 'normal' range of plasma CA for LTH patients has not been unequivocally established [9][10][11][12][13][14][15][16][17][18][19],…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Considerations in Pheochromocytoma and Chronic Hemodialysis: Case Report and Review of the Literature

Stümvoll

Radjaipour²,

Seif³

1995

Am J Nephrol

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We present a patient on long-term hemodialysis (LTH) discovered to have a pheochromocytoma. A thorough workup pertaining his catecholamine status was performed, and intraoperative catecholamine changes were monitored. This condition poses some analytical difficulties as both interpretation of plasma catecholamine measurements and determination of their metabolic products are impaired. The literature about catecholamines with respect to hemodialysis is reviewed, and the known cases of pheochromocytoma in LTH patients are discussed. Predialysis norepinephrine concentrations were almost consistently elevated though less than 3-fold when compared to normal controls. Epinephrine is not significantly different in both groups. At least a 3.3-fold increase of epinephrine or norepinephrine in LTH patients with adrenal pheochromocytomas is observed. We conclude that plasma epinephrine elevations can be evaluated in the conventional manner, and norepinephrine concentrations beyond a 3-fold elevation should raise the suspicion of a pathological catechol excess syndrome. The interpretation of plasma homovanillic acid and vanillylmandelic acid in this condition is complicated by the lack of data in LTH patients without pheochromocytoma. Markedly elevated baseline concentrations for these parameters are assumed.

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Autonomic Nervous System Dysfunction and Impotence in Uremia

Cited by 41 publications

References 1 publication

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

Effect of Haemodialysis on the Control of the Circulation in Patients with Chronic Renal Failure

Autonomic Nervous System Dysfunction and Volume Nonresponsive Hypotension in Hemodialysis Patients

Diagnostic Considerations in Pheochromocytoma and Chronic Hemodialysis: Case Report and Review of the Literature

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