Sympathetic Skin Response in Peritoneal Dialysis Patients

Abstract

To determine if there is any difference in nerve conduction studies or sympathetic skin response (SSR) between patients on peritoneal dialysis and those on regular hemodialysis, we did a cross-sectional observational study. The study group consisted of 24 patients on peritoneal dialysis (PD) (12 men, aged 45 +/- 17 years) and 20 patients on hemodialysis (HD) (11 men, aged 50 +/- 22 years). All of these patients were in stable clinical condition, they were receiving adequate dialysis, and none of them had systemic diseases. Motor and sensory nerve conduction studies of the common and medial peroneal nerve and SSR were performed in all patients. There were no differences in motor and sensory nerve conduction velocities between PD and HD patients. All PD patients had detectable SSR. However, six patients on HD (30%) failed to show SSR (p < 0.05). Mean SSR amplitude was higher in PD patients than in HD patients (1233 +/- 843 vs. 605 +/- 771 microv, p < 0.05). There were no differences in mean SSR latency between PD and HD patients. PD modality (continuous ambulatory PD vs. automated PD) or the presence of residual renal function did not influence nerve conduction studies or SSR. In conclusion, using standard nerve conduction studies, no differences could be found between HD and PD. However, a higher proportion of patients on HD showed an impaired SSR, suggesting that subclinical neuropathy may be more common in HD than PD patients.

Heart rate variability at rest and in response to stress: Comparative study between hemodialysis and peritoneal dialysis patients

“…Two studies examining cardiac and skin SNS response showed no differences between the two dialysis modalities. 39,40 Short-term blood pressure variability (BPV), a parameter closely related with ANS function and sympathetic versus parasympathetic drive, 41,42 was also not different between HD and PD patients in a recent study. 34…”

“…Two studies examining cardiac and skin SNS response showed no differences between the two dialysis modalities. 39,40 Shortterm blood pressure variability (BPV), a parameter closely related with ANS function and sympathetic versus parasympathetic drive, 41,42 was also not different between HD and PD patients in a recent study. 34 An exception to our aforementioned findings is the different response in some HRV indices during the recovery period following the sit-to stand test between the HD and PD groups.…”

Impairment of endogenous melatonin rhythm is related to the degree of chronic kidney disease (CREAM study)

“…Abnormalities in the rhythms in core and skin temperature have been reported in some patients with insomnia [35]. Dialysis patients show impaired nerve conduction, possibly due to uraemia [36]. Patients with proteinuria exhibit impaired vascular endothelial function, which can result in impairment in blood flow response to heating in the skin [37], which leads to less thermal conductivity [38].…”

Prediction of the Efficacy of Lumbar Sympathetic Block in Patients with Lower Extremity Complex Regional Pain Syndrome Type 1 Based on the Sympathetic Skin Response

“…The SSR latency and amplitude can be changed in response to sympathetic hyperactivity of CRPS because it alters the sweat fibers, which in turn influences skin resistance [ 22 ]. Additionally, SSR has been shown to have good consistency with other autonomic function detection methods in diabetic neuropathy [ 23 ], uremic peripheral neuropathy [ 24 ], chemotherapy-induced peripheral neuropathy [ 25 ] and other diseases and can well evaluate the autonomic function impairment of these diseases.…”