Korean Journal of Nephrology 1991;10(1):54-61.

만성신부전증 환자의 말초 및 자율신경장애에 관한 연구

김동웅 , 조정구 , 송주홍

Abstract

We studied several different methods for assessing the peripheral and autonomic nervous system dysfunction induced by chronic renal failure. The peroneal and sural nerve conduction study, respi- ratory sinus arrhythmia, lying and standing blood pres- sure response with heart rate change, Valsalva maneu- ver, hand grip exercise, autonomic score were perfor- med in 58 normals and 33 chronic renal failure patients admitted to Wonkwang University Hospital. The following results are obtained. 1) Peripheral nerve conduction examinations revealed significant reduction of amplitude and conduc- tion velocity in patients with chronic renal failure (p < 0.05). 2) Autonomic nervous system examinations found significant differences in respiratory sinus arrhythmia, lying and standing blood pressure response with heart rate change, Valsalva ratio, and autonomic scores be- tween in normals and patients with chronic renal failure (p < 0.05). 3) The Valsalva ratio was decreased with the increas- ing duration of chronic renal failure. 4) The frequency of abnormality in respiratory sinus arrhythmia and Valsalva ratio were more increased in patients with chronic renal failure than were abnormal- ities in hangrip exercise and postural blood pressure change. This result suggests that parasympathetic ner- vous dysfunction may precede the sympathetic dysfunc- tion in patients with chronic renal failure.