Abstract
A total of 263 patients were treated with chronic hemodialysis (HD group), the diagnosed disease being chronic glomerulonephritis in 204 cases, diabetic nephropathy in 12, pregnancy-related kidney disease in 12, polycystic kidneys in 7, chronic pyelonephritis in 7, nephrosclerosis in 6 and other diseases in 15. The control groups were 78 healthy volunteers (Coat group) and 160 diabetic patients (DM group). Autonomic nervous system disturbance was examined using the coefficent of variation of the R-R interval in ECG (referred to as CV below), as was the possible relationship of CV to variation in blood pressure (BP) and pulse rate during hemodialysis. The mean CV in the HD group was 2.2±1.0%. CV tended to decrease as age increased in all groups, decreasing in the order Cont group>DM group>HD group in all age groups examined. The downward trend of CV with increasing age was remarkable when the duration of hemodialysis was short; however, no constant trend was observed between hemodialysis duration and CV by age distribution. Mean CV varied according to disease. For chronic glomerulonephritis, the mean CV was 2.3±1.0%, close to the HD group mean. For diabetic nephropathy and nephrosclerosis, it was 1.2±0.6% and 1.4±0.4% respectively, both significantly lower than the overall mean value. On the other hand, the mean CV tended to be high for polycystic kidneys: 2.7±1.3%. Although hemodialysis-induced hypotension is said to be accompanied by autonomic nervous system dysfunction, the differences between the maximum and minimum values of systolic BP, diastolic BP and pulse rate were confirmed to have no correlation with CV in the present study.
