Neurophysiologic parameters and symptoms in chronic renal failure.
We studied: (1) the sensitivity of various neurophysiologic parameters in the diagnosis of uremic polyneuropathy, (2) the relationship between subjective symptoms and neurophysiologic parameters, and (3) the effect of a single hemodialysis on the neurophysiologic parameters in 21 patients undergoing hemodialysis. The following parameters were studied: sensory and motor nerve conduction, including F-wave parameters; vibration detection thresholds; and thermal thresholds. The clinical findings and subjective symptoms were studied using a standardized questionnaire. The most sensitive parameters in the diagnosis of uremic neuropathy were F-wave parameters from lower limbs, vibration detection thresholds from the feet, and the sural nerve sensory action potential amplitude. The nerves from the upper extremities on the side of the fistula should not be used in the diagnosis of uremic polyneuropathy due to numerous mild local nerve lesions. The positive neuropathic symptoms correlated with quantitative vibratory detection thresholds and sensory nerve conduction studies, especially the amplitude of the sensory nerve action potential in the sural nerve. We found no significant change in any of the neurophysiologic parameters following a single hemodialysis session.
Department of Clinical Neurophysiology, Turku University Hospital, PB 52, FIN-20521 Turku, Finland. satu.laaksonen@tyks.fi
Satu
S
Laaksonen
Kaj
K
Metsärinne
Liisa-Maria
LM
Voipio-Pulkki
Björn
B
Falck
D002908:Chronic Disease; D003080:Cold Temperature; D004568:Electrodiagnosis; D006358:Hot Temperature; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008274:Magnesium / Q000097:blood; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D010525:Peripheral Nerves / Q000503:physiopathology; D010812:Physical Stimulation; D011115:Polyneuropathies / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D012684:Sensory Thresholds; D013979:Tibial Nerve / Q000503:physiopathology; D014732:Vibration
D008274:Magnesium