title: Cardiovascular autonomic neuropathy studied by a laser-Doppler blood flowmeter in hemodialysis patients.
abstract: OBJECTIVE
  Orthostatic hypotension during a hemodialysis (HD) session affects not only the modality but daily quality of life for HD patients because many of them have combined dysfunction of both sympathetic and parasympathetic nervous systems. Although various non-invasive methods have been applied for the evaluation of autonomic function, no monitor has been devised for measuring the dysfunction during blood purification therapy.
  
  
  METHODS
  We evaluated the usefulness of laser-Doppler blood flowmeter (LDF) for measuring autonomic function of stable 34 regular HD patients and 24 healthy controls. The LDF device was applied for autonomic test by measuring periflux blood flow decreasing velocity (PDV) accompanied with Valsalva maneuver. We also evaluated the correlation between PDV and conventional tests for atherosclerosis.
  
  
  RESULTS
  The average PDV (3.79±1.77) in HD population level was significantly lower than that of healthy controls (8.72±6.00). We also found a significant correlation between PDV and conventional methods such as heart rate variability and ankle-brachial blood pressure index.
  
  
  CONCLUSIONS
  Measurement of PDV by LDF is as useful as a conventional method for evaluating autonomic function in HD patients. The convenience of the device offers the benefit of daily and frequent measurement of autonomic dysfunction.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, and Minami-Senju Hospital, Tokyo. kaokano@kc.twmu.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Okano
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsuruta
authors.forename: Tetsuri
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Echida
authors.forename: Takashi
authors.initials: T
authors.lastname: Kabaya
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation