A study of autonomic neuropathy in patientsof chronic renal failure

Several abnormalities in cardiovascular autonomic function have been found in chronic renal failure patients and it is associated with increase in mortality in these patients. So the study of autonomic neuropathy in patients of chronic renal failure was taken up. Methods: A study was done on clinical profiles of autonomic neuropathy in patients of chronic renal failure patients. Detailed clinical history, a thorough clinical examination, lab investigations and the following clinical tests for autonomic neuropathy were done. Heart rate variability in response to deep breathing, heart rate variability in response to standing, heart rate in response to Valsalva maneuver, blood pressure response to standing and BP response to sustained hand grip exercise were recorded. Values obtained from the various tests were tabulated into a worksheet. Result: Out of 100 patients, maximum numbers of patients belong to the age group of 50 - 60 years. In 43% of the chronic kidney disease patients the main cause was diabetes, while in 21% patients the important cause was hypertension. Symptoms suggestive of autonomic neuropathy were present in 64% patients. 42% patients had evidence of autonomic neuropathy.58.1% of them were diabetic patients and 29.8% of them were nondiabetic patients. Conclusion: Diabetes mellitus was the commonest etiology for chronic renal failure followed by hypertension and obstructive uropathy. Autonomic neuropathy is well associated with chronic renal failure patients. Knowledge of autonomic dysfunction canencourage patients and physicians to improve metabolic control.