Document Detail

Autonomic function in patients on continuous ambulatory peritoneal dialysis.
MedLine Citation:
PMID:  9527029     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate sympathetic function in the peripheries of patients on chronic ambulatory peritoneal dialysis (CAPD) using noninvasive techniques. DESIGN: Comparison of peripheral blood flow responses in sympathetic vasoconstrictor reflexes in CAPD patients and matched control subjects. SETTING: Tertiary care hospital and research institution. PATIENTS: Twenty-three clinically stable CAPD patients and 23 control subjects matched for age, sex, and drug therapy. MAIN OUTCOME MEASURES: Sympathetic activity assessed from the reductions in hand and foot blood flow induced by a deep breath and by body surface cooling. Cardiac autonomic activity measured by the changes in heart rate produced by deep breathing, a Valsalva maneuver, and standing from lying. RESULTS: A deep breath induced mean decreases in hand blood flow of 65.1% in the patients and 82.8% in their matched controls. Corresponding reductions in the foot were 46.0% and 70.0%. Body surface cooling reduced mean hand blood flow by 50.3% in the patients and 71.8% in the control subjects. Corresponding values in the foot were 26.7% and 43.6%. The differences in response between the patients and their matched control subjects were all significant (p < 0.01). Cardiac autonomic function assessed by standard tests of heart rate variability was significantly impaired in the patients compared with the control subjects in two of the three tests used (p < 0.001). CONCLUSIONS: Cardiovascular autonomic impairment can affect the peripheral circulation as well as the heart in patients on dialysis, and this may have implications for cardiovascular homeostasis.
S V Jassal; J A Allen; J F Douglas; R W Stout
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  18     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:    1998 Jan-Feb
Date Detail:
Created Date:  1998-05-27     Completed Date:  1998-05-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  46-51     Citation Subset:  IM    
Department of Geriatric Medicine, The Queen's University of Belfast, Northern Ireland.
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MeSH Terms
Case-Control Studies
Foot / blood supply,  innervation
Hand / blood supply,  innervation
Heart / innervation
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory*
Reflex / physiology*
Regional Blood Flow
Sympathetic Nervous System / physiology*
Vasoconstriction / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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