title: [Effects of kidney and pancreas transplantation on neurophysiological rates of polyneuropathy and autonomous cardiac function in diabetic patients with end-stage renal disease].
abstract: BACKGROUND
  Patients with type 1 diabetes mellitus (DM1) and end-stage renal disease (ESRD) usually exhibit a severe polyneuropathy (PNP) whose progression can be halted after kidney and pancreas transplantation (KPT). We studied the evolution of both PNP and autonomous cardioregulatory function (ACF) in patients with DM1 and ESRD within the first year after KPT. PATIENTS AND MEHTOD: The study was carried out in 26 patients who underwent KPT and whose organs were functioning normally at least during one year after KPT. They were examined neurophysiologically in three different periods: a) before KPT; b) 1-3 months after KPT, and c) 12 months after KPT. We evaluated PNP by measuring the conduction velocity (CV) and the amplitude of the compound action potentials (ACAP) of common peroneal, posterior tibial and sural nerves. ACF was evaluated by measuring the change in the interval separating two consecutive QRS complexes in the electrocardiogram during quiet breathing and Valsalva manoeuvre.
  
  
  RESULTS
  All patients had a severe PNP before KPT. Ten patients (38.4%) showed a significant reduction in ACAP and ACF in the exam carried out within 1 to 3 months after KPT, whereas all patients showed an increase in the CV, ACAP and ACF at 1 year after KPT.
  
  
  CONCLUSIONS
  KPT induces a significant improvement of neurophysiological signs of PNP and of ACF, which is statistically significant at 1 year after KPT. In some patients, the improvement is heralded by an increase in the axonal damage, occurring in the first months after KPT, which may be due the aggression from the surgical treatment and related events.
authors: Unitat d'EMG, Servicio de Neurología, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic, Universitat de Barcelona, Spain.
authors: Rolando
authors: R
authors: Agudo
authors: Josep
authors: J
authors: Valls-Solé
authors: Mónica
authors: M
authors: Recasens
authors: Neus
authors: N
authors: Fabregat
authors: María J
authors: MJ
authors: Ricart
authors: Enric
authors: E
authors: Esmatjes
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D003929:Diabetic Neuropathies / Q000150:complications / Q000601:surgery*; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation