Korean Journal of Nephrology 2000;19(6):1143-1149.

당뇨병 환자에서 신증 유무에 따른 자율신경기능의 차이 (The Difference of Autonomic Dysfunction according to the Absence or Presence of Nephropathy in NIDDM Patients)

김명임(Myung Im Kim),이태원(Tae Won Lee),고용호(Yong Ho Ko),나학열(Hak Yeol Na),이계원(Gye Won Lee),김희진(Hee Jin Kim),임천규(Chun Gyu Lim),김명재(Myung Jae Kim)

Abstract

In order to assess the difference of autonomic dysfunction according to the absence or presence of nephropathy in patients with NIDDM, tests for cardiovascular autonomic function were performed in 23 NIDDM patients without nephropathy(M:F 14:9, mean age 50±8) and in 21 patients with nephropathy (M:F 13:8, mean age 57±12). Tests for cardiovascular autonomic function included the R-R interval changes in response to respiration, Valsalva maneuver, and lying-standing, the blood pressure changes in response to lying-standing and sustained handgrip exercise. The prevalence of autonomic dysfunction was different between the patients without and with nephropathy(69.6% vs 85.7%). For patients without symptoms suggesting autonomic neuropathy, the significant differences were found in the change of R-R interval in response to respiration(22.16±21.30 vs 11.73±10.83; p=0.0390>, in the change of lying-standing blood pressure(10.63±9.70 vs 22.00±13.67; p=0.0044) and in the change of blood pressure during handgrip exercise(16.89±10.28 vs 84O±7.24; p=0.0065). These results suggested that autonomic neuropathy may occur more frequently in patients with diabetic nephropathy than diabetes mellitus without neuropathy.