Prevalence of autonomic dysfunction among pre-dialysis chronic kidney disease patients in a tertiary hospital, South East Nigeria.

Obinna Onodugo,Ejikeme Arodiwe,Ifeoma Ulasi,Chinwuba Ijoma,Birinus Ezeala,Julius Okoye,Nkiru Onodugo

doi:10.4314/ahs.v18i4.14

Abstract

Autonomic dysfunction (AD) has been recognized as an important contributor to the poor outcome in chronic kidney disease (CKD) patients. Several studies have reported abnormalities in heart rate variability (HRV) among these patients. To determine the prevalence of Autonomic Dysfunction (AD) in pre-dialysis Chronic Kidney Disease (CKD) patients in a tertiary hospital in South East Nigeria. A cross sectional study of eighty chronic kidney disease patients attending the renal unit out-patient in the University of Nigeria Teaching Hospital (UNTH) Enugu was carried out. Forty subjects, drawn randomly, who had no kidney disease served as control. Autonomic function was assessed with non - invasive cardiovascular tests including, measurement of resting tachycardia, orthostatic hypotension, heart rate response (HRR) to standing test, heart rate response to Vasalva manoeuvre and heart rate response to respiration. With the battery of 5 tests used to assess AD, the frequency of autonomic dysfunction in pre-dialysis chronic kidney disease patients was 51.3% compared to 7.5% in the control group. Heart rate response to standing was the most sensitive test to detect AD in this group of subjects. AD is a common problem among pre-dialysis CKD patients in Nigeria.

Highlights

In Nigeria and other parts of Africa, chronic kidney disease (CKD) is a common disease accounting for a significant proportion of patients dying in a typical hospital medical ward[1]
We set out in this study to determine the actual prevalence of autonomic dysfunction in pre-dialysis CKD patients, in a tertiary hospital located in the South Eastern part of Nigeria
In the CKD group, 30/80 patients were in stage 3 (37.5%; mean eGFR equal to 44.3 ± 7.6ml/min/1.73 m2), 32/80 patients were in stage 4 (40%; mean eGFR equal to 22.5 ± 4.2ml/min/1.73 m2), and 18/80 patients were in stage 5 (22.5%; mean eGFR equal to 13.3 ± 2.5ml/min/1.73 m2)

Summary

Introduction

In Nigeria and other parts of Africa, CKD is a common disease accounting for a significant proportion of patients dying in a typical hospital medical ward[1]. We set out in this study to determine the actual prevalence of autonomic dysfunction in pre-dialysis CKD patients, in a tertiary hospital located in the South Eastern part of Nigeria. Objectives: To determine the prevalence of Autonomic Dysfunction (AD) in pre-dialysis Chronic Kidney Disease (CKD) patients in a tertiary hospital in South East Nigeria. Results: With the battery of 5 tests used to assess AD, the frequency of autonomic dysfunction in pre-dialysis chronic kidney disease patients was 51.3% compared to 7.5% in the control group. Prevalence of autonomic dysfunction among pre-dialysis chronic kidney disease patients in a tertiary hospital, South East Nigeria. Afri Health Sci. 2018;18(4): 950-957. https://dx.doi.org/10.4314/ ahs.v18i4.14

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