Autonomic status in children with chronic pyelonephritis at the initial stages of chronic kidney disease

L.I. Vakulenko


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.


children; chronic pyelonephritis; chronic kidney disease; vegetative homeostasis; sympathetic hyperactivity


Bezruk VV. Nephrological aspects of hypertension in children and teenagers. Klinicna ta eksperimentalʹna patologia. 2013;12(4):133-137. (in Ukrainian).

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).

Gromnatska NM. Heart hemodynamic and vegetative homeostasis in children with metabolic syndrome. Sovremennaya pedyatriya. 2014;(62):80-84. (in Ukrainian).

Kondrashova VG, Vdovenko VY, Kolpakov IE, et al. Bowels microbiocenosis in children-residents of the radioactive contaminated areas. Gigijena naselenyh misc'. 2013;(61):258-264. (in Ukrainian).

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).

Masal'tsev AK, Meshcheriakova EE. Peculiarities of psycho-vegetative status in children with chronic pyelonephritis. Bulletin of Medical Internet Conferences. 2013;3(2):328. (in Russian). 

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).

Stepanova N. Sympathetic hyperactivity in chronic kidney disease pstients: from pathogenesis to treatment. Ukrainian Journal of Nephrology and Dialysis. 2013;(38):56-64. (in Ukrainian).

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.

Coffman TM. The inextricable role of the kidney in hypertension. J Clin Invest. 2014 Jun;124(6):2341-7. doi: 10.1172/JCI72274.

Ewen S, Ukena C, Linz D, Schmieder RE, Böhm M, Mahfoud F. The sympathetic nervous system in chronic kidney disease. Curr Hypertens Rep. 2013 Aug;15(4):370-6. doi: 10.1007/s11906-013-0365-0.

Phillips JK, Campos RR. Role of renal nerves in normal and pathophysiological conditions. Auton Neurosci. 2017 May;204:1-3. doi: 10.1016/j.autneu.2016.12.003.

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.

Kaur J,  Young BE,  Fadel PJ. Sympathetic Overactivity in Chronic Kidney Disease: Consequences and Mechanisms. Int J Mol Sci. 2017 Aug 2;18(8). pii: E1682. doi: 10.3390/ijms18081682.

Kiuchi MG, Mion D Jr. Chronic kidney disease and risk factors responsible for sudden cardiac death: a whiff of hope? Kidney Res Clin Pract. 2016 Mar;35(1):3-9. doi: 10.1016/j.krcp.2015.11.003.

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.

Park J. Cardiovascular risk in chronic kidney disease: role of the sympathetic nervous system. Cardiol Res Pract. 2012;2012:319432. doi: 10.1155/2012/319432.

Sobotka PA, Mahfoud F, Schlaich MP, Hoppe UC, Böhm M, Krum H. Sympatho-renal axis in chronic disease. Clin Res Cardiol. 2011 Dec;100(12):1049-57. doi: 10.1007/s00392-011-0335-y.

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.

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