Sympathetic skin response and R-R interval variation in chronic uremic patients.
Sympathetic skin response (SSR) and R-R interval variation (RRIV) were studied in 36 chronic, nondiabetic uremics to compare with their nerve conduction studies (NCS) and clinical dysautonomia. Abnormal SSR was noted in 5 (13.9%) patients, abnormal RRIV in 14 (38.9%), and abnormal NCS in 26 (72.2%). The patients were classified into three groups: group (GP) 1: "normal," n = 21 (58.3%), normal RRIV and SSR; GP 2: "isolated parasympathetic dysfunction," n = 10 (27.8%), abnormal RRIV and normal SSR; and GP 3: "sympathetic sudomotor dysfunction," n = 5 (13.9%), abnormal SSR. A significant difference in age was found among the three groups (GP 3 > GP 2 > GP 1; P < 0.0001, ANOVA). After controlling the age factor, we still noted a tendency toward increasing NCS disturbances (distal latency and nerve conduction velocity of peroneal nerve; P < 0.05, multiple regression analysis) and frequencies of clinical autonomic symptoms (postural dizziness and impotence; P < 0.05, Mantel-Hanszel test) from GP 1 to GP 3. Patients with abnormal SSR (GP 3) displayed significantly higher frequencies of postural dizziness and impotence, indicating the relationship between an absence of SSR and clinical dysautonomia.
Wang
S J
SJ
Neurological Institute, Veterans General Hospital-Taipei, Taiwan, ROC.
Liao
K K
KK
Liou
H H
HH
Lee
S S
SS
Tsai
C P
CP
Lin
K P
KP
Kao
K P
KP
Wu
Z A
ZA
D000368:Aged; D000704:Analysis of Variance; D001341:Autonomic Nervous System / Q000503:physiopathology; D004244:Dizziness; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010543:Peroneal Nerve / Q000503:physiopathology*; D011187:Posture; D006435:Renal Dialysis; D012867:Skin / Q000294:innervation*; D013497:Sural Nerve / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014511:Uremia / Q000503:physiopathology*