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Causes of autonomic dysfunction in idiopathic recurrent kidney stone formers

  • Nephrology – Original Paper
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Abstract

Background

A higher prevalence of hypertension and adverse cardiovascular outcomes has been reported in kidney stone formers (KSF). We performed this study with the purpose of evaluating the autonomic nervous system (ANS) activity in KSF.

Methods

We performed a 70° head-up tilt test in 30 idiopathic recurrent KSF aged 45.6 ± 12.1 years old (17 men: 13 women) and 30 healthy controls aged 42.0 ± 12.4 years old (17 women: 13 men). Thirteen KSF were hypertensive, and 17 were normotensive. Blood pressure (BP) and heart rate variability (HRV) were used for the non-invasive assessment of the efferent activity of the ANS. Discrete wavelet transform (DWT) was used to quantify the low-frequency (LF: 0.04–0.15 Hz) and high-frequency (HF: 0.15–0.4 Hz) components during several periods of tilt.

Results

The results showed significantly higher HR and BP in KSF, in both supine and tilt positions. DWT revealed diminished HRV in the kidney stone patients during head-up tilt, with no increase in the LF and greater decrease in the HF components. The differences in the HF component of HRV were associated with obesity and hyperuricosuria, but the abnormalities of the LF component were independent of the explanatory variables. The LF component of systolic BP was significantly higher in KSF and was associated with hypertension.

Conclusions

Several factors may contribute to the presence of autonomic dysfunction in patients with recurrent nephrolithiasis. This abnormality has significant implications in cardiovascular risk assessment and treatment planning.

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References

  1. Belova NY, Mihaylov SV, Piryova BG (2007) Wavelet transform: a better approach for the evaluation of instantaneous changes in heart rate variability. Auton Neurosci 131:107–122

    Article  PubMed  Google Scholar 

  2. Borghi L, Meschi T, Guerra A et al (1999) Essential arterial hypertension and stone disease. Kidney Int 55:2397–2406

    Article  PubMed  CAS  Google Scholar 

  3. Brunetto AF, Roseguini BT, Silva BM et al (2005) Cardiac autonomic responses to head-up tilt in obese adolescents. Rev Assoc Med Bras 51:256–260

    Article  PubMed  Google Scholar 

  4. Calhoun DA, Oparil S (2004) Hypertension and sympathetic nervous system activity. In: Robertson D, Biaggioni I, Burnstock G, Low PA (eds) Primer on the autonomic nervous system, 2nd edn. Elsevier, San Diego, pp 241–244

    Chapter  Google Scholar 

  5. Cappuccio FP, Siani A, Barba G et al (1999) A prospective study of hypertension and the incidence of kidney stones in men. J Hypertens 17:1017–1022

    Article  PubMed  CAS  Google Scholar 

  6. Cappuccio FP, Strazzullo P, Mancini M (1990) Kidney stones and hypertension: population based study of an independent clinical association. BMJ 300:1234–1236

    Article  PubMed  CAS  Google Scholar 

  7. Charkoudian N, Rabbitts JA (2009) Sympathetic neural mechanisms in human cardiovascular health and disease. Mayo Clin Proc 84:822–830

    Article  PubMed  Google Scholar 

  8. Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 289:2560–2572

    Article  PubMed  CAS  Google Scholar 

  9. Chou YH, Li WM, Li CC et al (2007) Clinical study of uric Acid urolithiasis. Kaohsiung J Med Sci 23:298–301

    Article  PubMed  CAS  Google Scholar 

  10. Cirillo M, Laurenzi M (1988) Elevated blood pressure and positive history of kidney stones: results from a population-based study. J Hypertens Suppl 6:S485–S486

    PubMed  CAS  Google Scholar 

  11. Cupisti A, Morelli E, Meola M et al (1996) Hypertension in kidney stone patients. Nephron 73:569–572

    Article  PubMed  CAS  Google Scholar 

  12. Davrath LR, Goren Y, Pinhas I et al (2003) Early autonomic malfunction in normotensive individuals with a genetic predisposition to essential hypertension. Am J Physiol Heart Circ Physiol 285:H1697–H1704

    PubMed  CAS  Google Scholar 

  13. Domingos F, Serra A (2010) Nephrolithiasis is associated with an increased prevalence of cardiovascular disease. Nephrol Dial Transplant. doi:10.1093/ndt/gfq501

  14. Ducla-Soares JL, Santos-Bento M, Laranjo S et al (2007) Wavelet analysis of autonomic outflow of normal subjects on head-up tilt, cold pressor test, Valsalva manoeuvre and deep breathing. Exp Physiol 92:677–686

    Google Scholar 

  15. Esler M (2000) The sympathetic system and hypertension. Am J Hypertens 13:99S–105S

    Article  PubMed  CAS  Google Scholar 

  16. Gillen DL, Coe FL, Worcester EM (2005) Nephrolithiasis and increased blood pressure among females with high body mass index. Am J Kidney Dis 46:263–269

    Article  PubMed  Google Scholar 

  17. Grisk O, Rettig R (2004) Interactions between the sympathetic nervous system and the kidneys in arterial hypertension. Cardiovasc Res 61:238–246

    Article  PubMed  CAS  Google Scholar 

  18. Lauer MS (2009) Autonomic function and prognosis. Cleve Clin J Med 76(Suppl 2):S18–S22

    Article  PubMed  Google Scholar 

  19. Madore F, Stampfer MJ, Rimm EB, Curhan GC (1998) Nephrolithiasis and risk of hypertension. Am J Hypertens 11:46–53

    Article  PubMed  CAS  Google Scholar 

  20. Madore F, Stampfer MJ, Willett WC et al (1998) Nephrolithiasis and risk of hypertension in women. Am J Kidney Dis 32:802–807

    Article  PubMed  CAS  Google Scholar 

  21. Mancia G, Grassi G, Giannattasio C, Seravalle G (1999) Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension 34:724–728

    PubMed  CAS  Google Scholar 

  22. Mark AL (1996) The sympathetic nervous system in hypertension: a potential long-term regulator of arterial pressure. J Hypertens Suppl 14:S159–S165

    PubMed  CAS  Google Scholar 

  23. Maser RE, Lenhard MJ (2005) Cardiovascular autonomic neuropathy due to diabetes mellitus: clinical manifestations, consequences, and treatment. J Clin Endocrinol Metab 90:5896–5903

    Article  PubMed  CAS  Google Scholar 

  24. Mathias CJ, Bannister R (1999) Investigation of autonomic disorders. In: Mathias CJ, Bannister R (eds) Autonomic failure—a textbook of clinical disorders of the autonomic nervous system, 4th edn. Oxford University Press, Oxford, pp 169–195

    Google Scholar 

  25. Mente A, Honey RJ, McLaughlin JM et al (2006) High urinary calcium excretion and genetic susceptibility to hypertension and kidney stone disease. J Am Soc Nephrol 17:2567–2575

    Article  PubMed  CAS  Google Scholar 

  26. Molfino A, Fiorentini A, Tubani L et al (2009) Body mass index is related to autonomic nervous system activity as measured by heart rate variability. Eur J Clin Nutr 63:1263–1265

    Article  PubMed  CAS  Google Scholar 

  27. Monda M, Messina G, Vicidomini C et al (2006) Activity of autonomic nervous system is related to body weight in pre-menopausal, but not in post-menopausal women. Nutr Neurosci 9:141–145

    Article  PubMed  CAS  Google Scholar 

  28. Piccirillo G, Munizzi MR, Fimognari FL, Marigliano V (1996) Heart rate variability in hypertensive subjects. Int J Cardiol 53:291–298

    Article  PubMed  CAS  Google Scholar 

  29. Piestrzeniewicz K, Luczak K, Lelonek M et al (2008) Obesity and heart rate variability in men with myocardial infarction. Cardiol J 15:43–49

    PubMed  Google Scholar 

  30. Radaelli A, Bernardi L, Valle F et al (1994) Cardiovascular autonomic modulation in essential hypertension. Effect of tilting. Hypertension 24:556–563

    PubMed  CAS  Google Scholar 

  31. Robertson WG, Peacock M, Baker M et al (1983) Studies on the prevalence and epidemiology of urinary stone disease in men in Leeds. Br J Urol 55:595–598

    Article  PubMed  CAS  Google Scholar 

  32. Rogowski O, Steinvil A, Berliner S et al (2009) Elevated resting heart rate is associated with the metabolic syndrome. Cardiovasc Diabetol 8:55

    Article  PubMed  Google Scholar 

  33. Rumantir MS, Vaz M, Jennings GL et al (1999) Neural mechanisms in human obesity-related hypertension. J Hypertens 17:1125–1133

    Article  PubMed  CAS  Google Scholar 

  34. Serra A, Domingos F (2006) Avaliação nefrológica de uma população com litíase cálcica idiopática recorrente, 1st edn. Laboratórios Bial, Porto

    Google Scholar 

  35. Strazzullo P, Barba G, Vuotto P et al (2001) Past history of nephrolithiasis and incidence of hypertension in men: a reappraisal based on the results of the Olivetti Prospective Heart Study. Nephrol Dial Transplant 16:2232–2235

    Article  PubMed  CAS  Google Scholar 

  36. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354–381

    Article  Google Scholar 

  37. Tisler A, Pierratos A, Honey JD et al (1999) Hypertension aggregates in families of kidney stone patients with high urinary excretion of uric acid. J Hypertens 17:1853–1858

    Article  PubMed  CAS  Google Scholar 

  38. Tisler A, Pierratos A, Honey JD et al (2002) High urinary excretion of uric acid combined with high excretion of calcium links kidney stone disease to familial hypertension. Nephrol Dial Transplant 17:253–259

    Article  PubMed  CAS  Google Scholar 

  39. van Ravenswaaij-Arts CM, Kollee LA, Hopman JC et al (1993) Heart rate variability. Ann Int Med 118:436–447

    PubMed  Google Scholar 

  40. Wiklund U, Akay M, Morrison S, Niklasson U (2002) Wavelet decomposition of cardiovascular signals for baroreceptor function tests in pigs. IEEE Trans Biomed Eng 49:651–661

    Article  PubMed  Google Scholar 

  41. Wyss JM, Carlson SH (2001) The role of the nervous system in hypertension. Curr Hypertens Rep 3:255–262

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by a grant from the Portuguese Foundation for Science and Technology (PIC/IC/83243/2007).

The authors want to thank to the Biomedical Engineer Cristiano Tavares, who developed the software FisioSinal, for having provided the software used in this work.

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Authors and Affiliations

  1. Instituto de Medicina Molecular and Institute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal

    Fernando Domingos & Alberto Escalda

  2. Instituto de Fisiologia, Faculdade de Medicina de Lisboa, Av Prof Egas Moniz, EEM Piso 1-A, 1649-028, Lisbon, Portugal

    Fernando Domingos

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  1. Fernando Domingos
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  2. Alberto Escalda
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Correspondence to Fernando Domingos.

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Domingos, F., Escalda, A. Causes of autonomic dysfunction in idiopathic recurrent kidney stone formers. Int Urol Nephrol 44, 873–882 (2012). https://doi.org/10.1007/s11255-011-9983-0

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  • DOI: https://doi.org/10.1007/s11255-011-9983-0

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