The course of autonomic neural function in chronic uraemic patients during haemodialysis treatment

Abstract

Autonomic function was followed in 19 patients with uraemia on chronic haemodialysis treatment over a period of 18 months. A smaller group of 12 patients were studied over 56 months. The battery of cardiovascular reflex tests included R-R interval variation test, deep breathing, Valsalva manoeuvre, heart rate, and blood pressure responses to standing and sustained handgrip. Two indices of autonomic function were measured: the autonomic score, and the confidence level on Bayesian analysis. There was great variability in the course of autonomic function over the period studied, with improvement occurring in some subjects and deterioration in others. In addition some patients did not develop any abnormality. Among those patients with uraemia and normal autonomic function at the start of the study, a deterioration occurred in 33-36% in the 18-month follow-up but in 62.5% in the 56-month follow-up. As a group there was no significant change in autonomic function during follow-up, although a clear trend to deterioration was found despite chronic haemodialysis treatment.