title: Cardiovascular autonomic neuropathy in chronic kidney diseases.
abstract: BACKGROUND
  This study was conducted to explore cardiovascular autonomic neuropathy and its pattern in chronic kidney disease patients.
  
  
  METHODS
  Autonomic function using five standard tests was examined in 20 diabetic patients with CKD, 20 age and sex matched diabetic patients without CKD and 20 age and sex matched controls. Analysis of difference between the autonomic function was done in the three groups using Chi-square test or Fischer's test.
  
  
  RESULTS
  Total 20 (100%) diabetic CKD patients were found to have autonomic neuropathy. Of these, 2 (10%) patients had early parasympathetic damage, 8 (40%) patients had definite parasympathetic damage, and 10 (50%) patients had combined damage. Heart rate response to standing was statistically significant (p = 0.014) among diabetic CKD patients when compared with diabetic patients without CKD. Combined form of autonomic dysfunction was more frequent in advanced stages of diabetic CKD. Three (42.85%) patients in stage 3 CKD, 4 (66.66%) patients in stage 4 CKD and 5 (71.42%) patients in stage 5 CKD, had combined autonomic failure.
  
  
  CONCLUSIONS
  Autonomic neuropathy is common in native Nepalese diabetic CKD patients. Heart rate response to standing is significantly abnormal in diabetic CKD patients in comparison with diabetes mellitus patient without CKD. Severity of autonomic dysfunction increases with severity of CKD..
authors.affiliation: Department of Neurology, CMSTH, Chitwan, Nepal. kushrajt@yahoo.co.in
authors.forename: L
authors.initials: L
authors.lastname: Thapa
authors.forename: P
authors.initials: P
authors.lastname: Karki
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
authors.forename: B K
authors.initials: BK
authors.lastname: Bajaj
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D014636:Valsalva Maneuver / Q000502:physiology