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Electrophysiological aspects of nervous conduction in uremia


Clinical Nephrology 29(5): 253-260
Electrophysiological aspects of nervous conduction in uremia
Some neurophysiological techniques have been employed in clinical nephrology to record abnormalities of nervous conduction in central and peripheral pathways. The electrical monitoring on the peripheral and central nervous systems has allowed the detection of uremic neural injury, the diagnosis of specific electrophysiological abnormalities, the evaluation of various treatments employed and the identification of those abnormalities that uremia can induce. A group of 156 subjects subdivided into four groups were examined: 100 healthy subjects (64 M, 36 F); 56 patients (21 glomerulonephritis, 14 pyelonephritis, 5 nephrolithiasis, 5 polycystic kidney, 4 nephroangiosclerosis, 7 undetermined) with chronic renal failure treated with a conventional low nitrogen diet (CLND, 0.6 g/kg b. w./d. of proteins), 8 of whom passed from CLND to a very low nitrogen diet supplemented with .alpha.-keto-analogues; a group of 22 of these 56 underwent a regular dialysis treatment for 12 to 15 hours/weekly for 40.5 .+-. 10.2 months. Three patietns of the CLND group and 13 patients underwent renal transplantation after a variable period of RDT. In the uremic patients we found different populations of motor unit potentials; a decreased MNCV was found in 35% of the CLND patients, RDT patients had slowed MNCV in 42%. The SNCV was compromised more frequently than the MNCV. An increased duration of evoked potentials was sometimes observed in CLND and RDT patients inducing us to consider this a hallmark of uremic syndrome. The .alpha.-keto-analogues and HD/HP treated patients showed an improvement in several features. The electrophysiological evaluation of the central and peripheral nervous system, using evoked potentials remains informative and relevant to the uremic syndrome, although the etiology and the pathophysiology of the abnormalities are elusive. The analysis of multimodal evoked potentials used to evaluate patients treated by CLND, RDT or transplantation can indicate diffuse structural and/or functional abnormalities depending on the variety of alterations observed.


Accession: 005349466

PMID: 3396225



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