Peripheral Neurophathies Associated With Chronic Renal Failure

Canadian Journal of Neurological Sciences - Tập 7 Số 2 - Trang 89-96 - 1980
C. F. Bolton1
1Department of Clinical Neurological Sciences, Victoria Hospital, University of Western Ontario, London, and the Department of Medicine, University Hospital, University of Saskatchewan, Saskatoon, Canada

Tóm tắt

SUMMARY:

A variety of peripheral nerve disorders may be associated with chronic renal failure. The polyneuropathy due to uremic toxins is a distal, motor and sensory polyneuropathy in which there is segmental demyelination, axonal degeneration, and segmental remyelination. The nature of the uremic toxin and the underlying mechanism of these changes is unknown.

The incidence in patients with “endstage” renal disease has fallen in recent years, severe cases now being rare, perhaps due to refinements in chronic hemodialysis, transplantation, and other therapies. However, while chronic hemodialysis stabilizes uremic neuropathy, manipulation of hemodialysis schedules may not alter its course, according to current assessment. Successful renal transplantation improves both the clinical and electrophysiological signs, even in severe uremic neuropathy.

Từ khóa


Tài liệu tham khảo

10.1016/S0140-6736(77)92116-X

10.1212/WNL.23.1.78

10.1136/jnnp.38.9.881

Bolton, 1975, Electrophysiological signs of peripheral neuropathy during chronic hemodialysis, International Congress of Electromyography, Rochester, Minn., U.S.A.

10.1136/jnnp.40.1.39

10.1016/0022-510X(77)90212-X

10.1016/0002-9343(68)90255-6

Osler, 1892, The principles and practice of medicine, 684

Teckhoff, 1967, The effect of long-term dialysis treatment on the course of uremic neuropathy, Trans. Am. Soc. Artif. Intern. Organs, 13, 58

10.1002/ana.410040413

10.1111/j.0954-6820.1971.tb07401.x

10.1136/jnnp.34.2.121

10.1056/NEJM197403212901203

Blair, 1977, Personal Communication

Editorial, 1971, Erythrocyte transke-tolase inhibition, neuropathy and uremia, N. Engl. J. Med, 284, 1435, 10.1056/NEJM197106242842511

10.1136/jnnp.41.1.65

10.1212/WNL.20.7.649

Casano A.A . (1972). Personal Communication.

10.1001/archneur.1971.00480350083009

Buchthal, 1975, In Peripheral Neuropathy, 1, 442

Babb, 1971, The genesis of the square meter-hour hypothesis, Trans. Am. Soc. Artif. Intern. Organs, 17, 81

10.1093/brain/94.4.761

10.1056/NEJM197004232821706

10.1136/jnnp.33.5.605

10.1056/NEJM197105272842102

10.1212/WNL.29.3.354

Dobbelstein, 1968, Periphere neuropathie bei chronis-chen niereninsuffizienz, bei dauerdialyse -behandlung und nach nierentransplantation, Med. Klin, 63, 616

10.1136/jnnp.35.5.631

Dyck, 1975, Detection and evaluation of uremic peripheral neuropathy in patients on hemodialysis, Kidney international, 7, 201

Funck-Brentano, 1978, A defense of the middle molecule hypothesis, Kidney International, 13, 31

Lowitzsch, 1979, Refractory period, sensory conduction velocity and vibration before and after haemo-dialysis, Acta Neurol. Scandinavica, 60, 133

Nielsen, 1972, The peripheral nerve function in chronic renal failure. IV. An analysis of the vibratory perception threshold, Acta Med. Scand., 191, 287

10.1136/jnnp.40.5.511

10.1136/bmj.2.5472.1212

10.1111/j.0954-6820.1974.tb00972.x

Bolton, 1977, Uremic neuropathy in patients on different hemodialysis schedules, Neurology, 27, 396

10.1136/jnnp.41.2.128

10.1111/j.0954-6820.1971.tb07403.x

Asbury, 1975, Peripheral Neuropathy, 982

10.1093/brain/92.2.459

10.1056/NEJM196708172770702

Baltzan, 1971, Clinical value of cadaveric renal homotransplantation, Can. Med. Assoc. J, 104, 293

Dyck, 1971, Segmental demyelination secondary to axonal degeneration in uremic neuropathy, Mayo Clin. Proc, 46, 400

10.1212/WNL.26.2.152

10.1016/S0140-6736(63)92287-6

10.1136/jnnp.39.3.258

Charcot, 1880, XVI des paraplégies urinaires, 295

10.1001/archneur.1963.00460040083008

Lambert, 1975, Peripheral Neuropathy, 1, 241

10.1136/jnnp.42.9.810

10.1093/brain/92.3.639

10.1159/000179946

10.1212/WNL.29.10.1361

Bolton, 1976, In Regional Management of Terminal Renal Failure: Review and Eternal Audit

Bolton, 1971, St. Johns, 16

10.1001/archinte.1971.00310200071006

Bolton, 1970, Uremic neuropathy during hemodialysis and following renal transplantation, Ann. R. Coll. Physicians Surg. Can., 2, 37

Bolton, 1979, In Strauss and Welt’s Diseases of the Kidney, 1, 371

10.1016/S0140-6736(73)91143-4