Uremic autonomic neuropathy

Autonomic symptoms are frequently encountered in chronic renal disease patients, either as a part of distal symmetric polyneuropathy and small fiber sensory polyneuropathy or as primary autonomic polyneuropathy independent of somatic neuropathy. Pathogenesis of latter remains elusive. Sudomotor, gastrointestinal and cardiological involvement is common. Renal replacement therapies are not as efficacious in curing autonomic neuropathy as in somatic polyneuropathy of uremia. A greater awareness of this entity across various disciplines and subsequent multidisciplinary approach involving nephrologists, gastroenterologist and cardiologist, as needed, is probably the best bet at present, to ease the suffering patient.