AUTONOMIC NERVOUS FUNCTION IN PATIENTS WITH CHRONIC-RENAL-FAILURE AT THE KENYATTA-NATIONAL-HOSPITAL

Autonomic nervous function was assessed in twenty two patients (16 mal es and 6 females) with chronic renal Failure on conservative managemen t. The presenting symptoms were postural dizziness in 10(45%), impoten ce in 4(18%) patients and 1 patient each with diplopia, urinary urgenc y and nocturnal diarrhoea. The following autonomic function tests were performed; valsalva manoeuvre, heart rate response to deep breathing, heart rate response to posture and postural change in blood pressure. Fifteen (68%) patients had abnormal autonomic function tests. Out of these patients, 14(93%) had abnormalities of the parasympathetic syste m and only one had abnormalities in the sympathetic system. There was a negative correlation between the creatinine levels and the following ; valsalva ratio (r=-0.72 p<0.001), heart rate response to standing (r =-0.56 p<0.01) and heart rate response to deep breathing (r=-0.45 p<0. 05).