AUTONOMIC STATUS OF PERITONEAL DIALYSIS PATIENTS AND ITS RELATION WITH INDICATORS OF LIPID METABOLISM

Abstract

The research objective had been to evaluate the autonomic status in peritoneal dialysis (PD) patients and to identify its lipid metabolism interaction. Patients and methods. During the research process 40patients had been examined who received continuous ambulatory peritoneal dialysis (CAPD). The autonomic status was studied using the questionnaire (A.N. Wayne test) and sympathetic skin response (SSR) by electroneuromyograph «Neuro–MEP–4». 20 conventionally healthy individuals formed the control group matched according to age and sex. Results. Obtained questionnaire data showed clinical symptoms of autonomic dysfunction in 37 cases among 40 (92,5%) PD patients. Analysis of the correlation level of autonomic disorders with lipid metabolism showed a significant dependence with the concentration of high density lipoprotein (HDL) (p=–0,43;p=0,01), low density lipoprotein (LDL) (p=0,55; p=0,001) and atherogenic index. Also a comparative analysis of the main CSAP PD patients’ indicators and conditionally healthy individuals showed a statistically significant decrease in the amplitudes of the first and second phases of SSR. Also SSR results analysis in conjunction with the autonomic disorders clinical implications afforded the ground for the lower extremities polyneuropathy diagnosis in 18 cases among 25 (72%) patients. Moreover, the study of lipid profile showed the correlation of total cholesterol (TC) with all studied SSR parameters: A1 (r=0,64; p=0,0006), A2 (r=0,79; p<0,0001), latent period (LP) (r=–0,45; p=0,04). Conclusions. The autonomic status of CAPD patients is characterized by low level of vegetative regulation total power and the imbalance of sympathetic and parasympathetic influences in comparison with conventionally healthy individuals and it is correlated with lipid spectrum.

Keywords

• peritoneal dialysis, autonomic status, uremic polyneuropathy, autonomic dysfunction, hyperglycemia, lipid metabolism, surveys, sympathetic skin response.