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Kidney Week

Abstract: TH-PO442

Evaluation of Autonomic Modulation in Normotensive Autosomal Dominant Polycystic Kidney Disease Patients

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Cystic

Authors

  • Rocha, Daniel Ribeiro da, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Ormanji, Milene Subtil, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Matos, Ana Cristina, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Bergamaschi, Cassia T., Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Campos, Ruy R., Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Silva, Bruno Moreira, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
  • Heilberg, Ita Pfeferman, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil
Background

Autonomic cardiovascular dysregulation has been described among Autosomal Dominant Polycystic Kidney Disease (APDKD) patients exhibiting hypertension and reduced kidney function. The present study aimed to evaluate the involvement of the sympathetic nervous system (SNS) preceding the onset of hypertension and kidney dysfunction.

Methods

We measured resting Heart Rate Variability (HRV) and systolic and diastolic arterial blood pressure (sBP and dBP) for five minutes in Finapres® device and cardiovascular reactivity after sympathoexcitatory stimuli: Stroop colored word test (SCWT), cold pressor test (CPT), and isometric handgrip (HG). Baroreflex sensitivity (BRS) was analyzed through the Valsalva maneuver (VM). Thirteen (13) ADPKD normotensive patients (5M/ 8F, 25.9±5.7 years old) and 13 healthy subjects (HS, 6M/7F, 26.1±4.6 yrs), eGFR of 104.8±18.6 and 104.9±11.0 mL/min/1.73m2, respectively, were included.

Results

Mean values of HR, BP, and HRV parameters at resting were not statistically different between groups.Although resting systolic BP (sBP) was similar for both groups, mean peak-phase-II-sBP and nadir-phase-III-sBP during VM were significantly higher in ADPKD versus HS (165.9±20.1 vs 142.5±19.7 and 140.2±11.7 vs 116.9±15.8 mmHg, p<0.05, respectively). Absolute differences between mean values of HR before and during CPT (at 2 minutes) were bigger in the ADPKD group (8.7±5.3 vs 2.9±5.6 bpm, p<0.05). Absolute differences between mean values of sBP and dBP before and during HG test (at 2 minutes) were smaller in ADPKD group than HS for sBP (11.8±8.1 vs 21.6±13.9 mmHg, p<0.05) and dBP (8.1±7.9 vs 14.7±8.1 mmHg, p<0.05). Absolute differences between mean values of HR during HG test and at 2 minutes of the recovery period were smaller in ADPKD than HS (-3.4±5.6 vs -10.5±9.0 bpm, p<0.05).Responses of HR and BP to SCWT did not differ between groups.

Conclusion

Preliminary data from VM and CPT as well as the delay in BP and HR returning to basal values observed in HG test suggested an increase in sympathetic drive in ADPKD normotensive patients.An additional number of patients need to be further evaluated to confirm present findings.

Funding

  • Government Support – Non-U.S.