Autonomic status in children with chronic pyelonephritis at the initial stages of chronic kidney disease
Background. The determination of vegetative homeostasis in children is one of the components of the assessment of the organism adaptive mechanisms in chronic pathology. The purpose was the evaluation of vegetative homeostasis to estimate the formation and severity of adaptive mechanisms in children and adolescents with chronic pyelonephritis. Materials and methods. One-hundred and fifteen children aged from 6 to 17 years (53 boys, 62 girls) without exacerbation of chronic pyelonephritis were examined. The control group consisted of 60 apparently healthy children at the same age. The state of the autonomic nervous system was assessed by the parameters of the initial vegetative tone, vegetative reactivity, vegetative control of the activity using cardiointervalography and orthostatic test. Results. The patients with chronic pyelonephritis presented enhanced activity of sympathetic nervous system and depressed parasympathetic tone in the initial vegetative tone. Furthermore, tension index, reflecting the degree of stress regulating mechanisms, statistically significantly exceeded the normal values in patients with II–III stage chronic kidney disease in all age groups. With the chronic kidney disease progressing, the hypersympathicotonic variant of vegetative reactivity changed to asympathicotonic. Thus, the pathological variants predominate in autonomic control of the cardiac activity in patients with chronic pyelonephritis. This testifies the progressive deficiency and depletion of adaptive resources of an organism. Conclusions. Changes in vegetative homeostasis in patients with chronic pyelonephritis show tension of the adaptive mechanisms of the cardiovascular system and a significant reduction of adaptive capacity.
Full Text:PDF (Українська)
Biyanov AN, Sofronova LV, Zubov ЕV. The use of cardiorhythmography in the formation of arterial hypertension risk groups in adolescents. Sovremennye Tehnologii v Meditsine. 2013;5(1):110-112. (in Russian).
Vein AM, Voznesenskaia TG, Vorob'eva OV, Golubev VL, authors; Vein AM, editor. Vegetativnye rasstroistva: klinika, diagnostia, lechenie [Vegetative disorders: clinic, diagnosis, treatment]. Moscow: MІА; 2010. 637 р. (in Russian).
Majdannyk VG, Mitjurjajeva-Kornijko IO, Kuhta NM, Gnyloskurenko AV. Vegetatyvni dysfunkcii' u ditej. Paroksyzmal'na vegetatyvna nedostatnist' [Vegetative dysfunction in children. Paroxysmal autonomic failure]. Kyiv: Logos; 2017. 300 р. (in Ukrainian).
Negerish AV, Tymchenko SL, Kazachkina EV, Yevstaf'yeva EV. Heart rate variability of children 10-11 years depending on the content of zinc, copper, calcium and strontium in the body. Perinatologiya i pediatriya. 2011;(47): 53-56. (in Russian).
Podzolkov VI, Bragina AE. Сhronic kidney disease as a multidisciplinary problem of contemporary medicine. Terapevticheskiy arkhiv. 2018;90(6): 121-129. doi: 10.26442/terarkh2018906121-129. (in Russian).
Timofeeva EP, Ryabichenko TI, Skosyreva GA, Kartseva TV. The autonomic nervous system in 15-17-year-old adolescents. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2016;61(4):82-87. doi: 10.21508/1027-4065-2016-61-4-82-87. (in Russian).
Burnstock G, Loesch A. Sympathetic innervation of the kidney in health and disease: Emphasis on the role of purinergic cotransmission. Auton Neurosci. 2017 May;204:4-16. doi: 10.1016/j.autneu.2016.05.007.
Grassi G, Quarti-Trevano F, Seravalle G, et al. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension. 2011 Apr;57(4):846-51. doi: 10.1161/HYPERTENSIONAHA.110.164780.
Masuo K, Lambert GW, Esler MD, Rakugi H, Ogihara T, Schlaich MP. The role of sympathetic nervous activity in renal injury and end-stage renal disease. Hypertens Res. 2010 Jun;33(6):521-8. doi: 10.1038/hr.2010.35.
Vink EE, de Jager RL, Blankestijn PJ. Sympathetic hyperactivity in chronic kidney disease: pathophysiology and (new) treatment options. Curr Hypertens Rep. 2013 Apr;15(2):95-101. doi: 10.1007/s11906-013-0328-5.
Copyright (c) 2020 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020