Accelerated neuropathy of renal failure.
OBJECTIVE
To describe a syndrome of rapidly evolving polyneuropathy in patients with severe renal failure.


METHODS
Retrospective case series of four patients.


METHODS
In-hospital evaluations and personal examinations of patients.


METHODS
Four patients with severe or end-stage renal failure who were receiving peritoneal dialysis.


RESULTS
These patients had an acute or subacute syndrome characterized by generalized limb weakness over days or weeks, severe imbalance, diminished reflexes, and numbness. Spinal fluid protein levels were elevated and some demyelinating features were noted on electrophysiological testing. Improvement occurred with more frequent peritoneal dialysis in one patient and transplantation in another, but the neuropathy progressed in the other two in whom diabetes may have played a role.


CONCLUSIONS
This partly reversible acute uremic neuropathy, which is probably caused by the metabolic disturbances of end-stage renal failure, simulates Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy and may be complicated by diabetic neuropathy.
Neurology Service, St Elizabeth's Hospital, Boston, Mass 02135.
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Ropper
D000328:Adult; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology; D004594:Electrophysiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000134:cerebrospinal fluid / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000503:physiopathology