Kivonat:
To evaluate the presence of autonomic neuropathy in childhood uremia,
cardiovascular autonomic reflexes were examined in children with
chronic renal failure. Cardiovascular autonomic reflexes of 10 uremic
patients on chronic dialysis and 10 transplanted patients were compared
to assess the effect of transplantation on autonomic neuropathy.
Resting heart rate, heart rate changes induced by deep breathing, by
Valsalva maneuver, and following standing up, and blood pressure change
induced by handgrip test were examined. Of the 10 uremic children, 4
showed early involvement and 2 had definite involvement of autonomic
neuropathy. Only 1 of the 10 transplanted patients showed early signs
of autonomic neuropathy. Autonomic tests demonstrated predominantly
parasympathetic dysfunction. In conclusion, cardiovascular autonomic
neuropathy is not rare in children and adolescents and young adults
with chronic renal failure. In contrast, the prevalence is very low in
transplanted patients with similar uremic precedents. Efforts should be
made to prevent or delay this uremia-related complication.