J Clin Neurol.  2010 Sep;6(3):143-147. 10.3988/jcn.2010.6.3.143.

There is No Association between Cardiovascular Autonomic Dysfunction and Peripheral Neuropathy in Chronic Hemodialysis Patients

• Stamboulis E
• Voumvouraki K
• Zambelis T
• Andrikopoulou A
• Vlahakos D
• Tsivgoulis A
• Rallis D
• Tsivgoulis G

• KMID: 1462850
• DOI: http://doi.org/10.3988/jcn.2010.6.3.143

Abstract

BACKGROUND AND PURPOSE
The potential association between the severity of autonomic dysfunction and peripheral neuropathy has not been extensively investigated, with the few studies yielding inconsistent results. We evaluated the relationship between autonomic dysfunction and peripheral neuropathy in chronic hemodialysis patients in a cross-sectional study.
METHODS
Cardiovascular autonomic function was assessed in 42 consecutive patients with chronic renal failure treated by hemodialysis, using a standardized battery of 5 cardiovascular reflex tests. Symptoms of autonomic dysfunction and of peripheral neuropathy were evaluated using the Autonomic Neuropathy Symptom Score (ANSS) and the Neuropathy Symptoms Score. Neurological deficits were assessed using the Neuropathy Disability Score. Conduction velocities along the sensory and motor fibers of the sural and peroneal nerves were measured. Thermal thresholds were documented using a standardized psychophysical technique.
RESULTS
Parasympathetic and sympathetic dysfunction was prevalent in 50% and 28% of cases, respectively. Peripheral neuropathy was identified in 25 cases (60%). The prevalence of peripheral neuropathy did not differ between patients with impaired (55%) and normal (75%) autonomic function (p=0.297; Fisher's exact test). The electrophysiological parameters for peripheral nerve function, neuropathic symptoms, abnormal thermal thresholds, age, gender, and duration of dialysis did not differ significantly between patients with and without autonomic dysfunction. Patients with autonomic dysfunction were more likely to have an abnormal ANSS (p=0.048). The severity of autonomic dysfunction on electrophysiological testing was positively correlated with ANSS (r=0.213, p=0.036).
CONCLUSIONS
The present data indicate that although cardiovascular autonomic dysfunction is prevalent among patients with chronic renal failure, it is not associated with the incidence of peripheral neuropathy.

Keyword

autonomic dysfunction; hemodialysis; neuropathy; cardiovascular reflexes

MeSH Terms

Cross-Sectional Studies
Dialysis
Humans
Incidence
Kidney Failure, Chronic
Organic Chemicals
Peripheral Nerves
Peripheral Nervous System Diseases
Peroneal Nerve
Prevalence
Reflex
Renal Dialysis
Organic Chemicals

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