Autonomic nervous system dysfunction in peritoneal dialysis patients: an underrecognized cardiovascular risk factor?

被引:1
作者
Faitatzidou, Danai [1 ]
Karagiannidis, Artemios G. [1 ]
Theodorakopoulou, Marieta P. [1 ]
Xanthopoulos, Andrew [2 ]
Triposkiadis, Filippos [2 ,3 ]
Sarafidis, Pantelis A. [1 ,4 ]
机构
[1] Aristotle Univ Thessaloniki, Hippokrat Hosp, Dept Nephrol 1, Thessaloniki, Greece
[2] Univ Hosp Larissa, Dept Cardiol, Larisa, Greece
[3] European Univ Cyprus, Sch Med, Nicosia, Cyprus
[4] Aristotle Univ Thessaloniki, Hippokrat Hosp, Dept Nephrol, Konstantinoupoleos 49, GR-54642 Thessaloniki, Greece
关键词
autonomic dysfunction; peritoneal dialysis; ESKD; cardiovascular risk; HEART-RATE-VARIABILITY; BAROREFLEX EFFECTIVENESS INDEX; CHRONIC KIDNEY-DISEASE; CHRONIC-RENAL-FAILURE; ALL-CAUSE MORTALITY; BLOOD-PRESSURE; SPECTRAL-ANALYSIS; SYMPATHETIC HYPERACTIVITY; HYPERTENSIVE PATIENTS; HEMODIALYSIS-PATIENTS;
D O I
10.1159/000534318
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: In patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) cardiovascular events represent the predominant cause of morbidity and mortality, with cardiac arrhythmias and sudden death being the leading causes of death in this population. Autonomic nervous system (ANS) dysfunction is listed among the non-traditional risk factors accounting for the observed high cardiovascular burden, with a plethora of complex and not yet fully understood pathophysiologic mechanisms being involved.Summary: In recent years, preliminary studies have investigated and confirmed the presence of ANS dysfunction in PD patients, while relevant results from cohort studies have linked ANS dysfunction with adverse clinical outcomes in these patients. In light of these findings, ANS dysfunction has been recently receiving wider consideration as an independent cardiovascular risk factor in PD patients. The aim of this review is to describe the mechanisms involved in the pathogenesis of ANS dysfunction in ESKD and particularly PD patients and to summarize the existing studies evaluating ANS dysfunction in PD patients. Key messages: ANS dysfunction in PD patients is related to multiple complex mechanisms that impair the balance between SNS/PNS and this disruption represents a crucial intermediator of cardiovascular morbidity and mortality in this population.
引用
收藏
页码:37 / 55
页数:19
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