Intravenous methylcobalamin treatment for uremic and diabetic neuropathy in chronic hemodialysis patients.
OBJECTIVE
To study the effects of the intravenous administration of methylcobalamin, an analogue of vitamin B12, for uremic or uremic-diabetic polyneuropathy in patients who are receiving maintenance hemodialysis. An ultra-high dose of vitamin B12 has been reported to promote peripheral nerve regeneration in experimental neuropathy.


METHODS
Nine patients received a 500 microg methylcobalamin injection 3 times a week for 6 months. The effects were evaluated using neuropathic pain grading and a nerve conduction study.


RESULTS
Serum concentrations of vitamin B12 were ultra-high during treatment due to the lack of urinary excretion. After 6 months of treatment, the patients' pain or paresthesia had lessened, and the ulnar motor and median sensory nerve conduction velocities showed significant improvement. There were no side effects.


CONCLUSIONS
Intravenous methycobalamin treatment is a safe and potentially beneficial therapy for neuropathy in chronic hemodialysis patients.
Department of Neurology, Chiba University School of Medicine.
S
S
Kuwabara
R
R
Nakazawa
N
N
Azuma
M
M
Suzuki
K
K
Miyajima
T
T
Fukutake
T
T
Hattori
D000200:Action Potentials; D000368:Aged; D002908:Chronic Disease; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006435:Renal Dialysis; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
C019476:mecobalamin; D014805:Vitamin B 12