| [ Summary ] |
Patients with chronic renal failure often display a variety of disturbances in the function of the autonomic nervous system. Autonomic neuropathy includes defective autonomic control of the cardiovascular system, dysfunction of gastrointestinal motility, impotence and defective sweat gland function. Reduced baroreceptor sensitivity is especially noted with hypotension during hemodialysis and plays an important role in mortality rates for hemodialysis patients. The pathogenesis of uremic autonomic neuropathy is still unknown and the toxic substances related to dysfunction have not been identified. To quantify generalized autonomic failure, a composite autonomic scoring scale was proposed, involving the coefficient of variation of R-R intervals, the Valsalva maneuver and response to orthostasis. Uremic autonomic damage is somewhat irreversible and requires a long time to be repaired in transplant patients. |