Inflammatory demyelinating neuropathy in patients with end-stage renal disease receiving continuous ambulatory peritoneal dialysis (CAPD)
OBJECTIVE
To report on 3 patients with inflammatory demyelinating peripheral neuropathy in strong temporal coincidence with the initiation of peritoneal dialysis (PD) therapy.


METHODS
Nephrology and Neurology Department of the University Hospital, Munich, Germany.


METHODS
Three patients with end-stage renal failure presented with the clinical picture of inflammatory demyelinating peripheral neuropathy within 4 to 10 weeks after start of continuous ambulatory peritoneal dialysis (CAPD). They had acute or subacute onset of lower extremity or generalized weakness, diminished reflexes, elevated spinal fluid protein levels, and signs of demyelinating neuropathy on electrophysiological testing.


METHODS
Clinical follow-up, nerve conduction studies, cerebral spinal fluid (CSF).


RESULTS
All patients did not improve under intensified PD therapy but took profit from immunomodulatory therapy. One bed-bound patient improved after change to hemodialysis and showed complete remission after renal transplantation.


CONCLUSIONS
Because of strong temporal coincidence, a causal relationship between CAPD and inflammatory demyelinating peripheral neuropathies can be suspected in these 3 patients.
Toepfer
M
M
Friedrich Baur Institute, Department of Nephrology, Medizinische Klinik, Ludwig Maximilians University, Munich, Germany.
Schiffl
H
H
Fricke
H
H
Lochmüller
H
H
Held
E
E
Pongratz
D
D
Müller-Felber
W
W
D000328:Adult; D003711:Demyelinating Diseases / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000209:etiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*