Clinical Aspects of Uraemic Polyneuropathy

Abstract

In order to establish the relationship between uraemic polyneuropathy and impairment of renal function, 83 patients with severe renal insufficiency not treated by maintenance dialysis were neurologically examined, most of them repeatedly in the course of their disease. Signs of neuropathy were found only when the creatinine clearance was 5 ml/min or less. The risk of incapacitating neuropathy was present in patients with a creatinine clearance of 3 ml/min or less. Polyneuropathy was found most frequently in patients with the highest blood urea and creatinine levels and the lowest creatinine clearances, but the duration of the period during which renal insufficiency had been severe appeared to be of influence as well. Polyneuropathy could be correlated more closely with the level of breakdown products of protein metabolism in the blood than with the blood creatinine level. The motor conduction velocity of the lateral popliteal nerve was examined in 50 patients. When polyneuropathy progressed, the conduction velocity fell to 50% of the normal value. The protein level of the CSF was raised in most patients with a severe polyneuropathy. Polyneuropathy was assessed in 20 patients treated by maintenance dialysis; it was compared to polyneuropathy in patients without this treatment.

The Peripheral Nerve Function in Chronic Renal Failure

“…The high incidence of impaired nerve function before dialysis, especially of slowed nerve conduc-tion, is consistent with most comparable reports (3, 5,7,8,9,10,12,21). This was also expected from the strong correlation with the kidney function (&) previously reported (17).…”

Long-term exposure to jet fuel: an investigation on occupationally exposed workers with special reference to the nervous system.

“…This inquiry was used by the present authors in earlier investigations on industrial workers exposed to carbon disulfide (25) and lead (26,27). The examined persons were thus questioned as to the occurrence of restless legs (6,24), muscle cramps, pain in the extremities, distal paresthesia and numbness, and paresis. For the evaluation of neurasthenia and polyneuropathy symptoms the same standardized criteria were used as in our earlier investigations on industrial workers, i.e., a symptom was considered "positive" when the subject experienced it at a frequency exceeding once a month.…”

Pentose Phosphate Pathway of Erythrocytes in Uremia

“…These findings corroborated our earlier observations [8] according to which the red cell TKA in uremia was normal or occasion ally higher than normal. Jennekens et al [4] also found that the TKA was normal in uremia, although the patients were affected with neuritis. Rizzo and V arasi [13] found that the TKA in uremia was significantly higher than in the controls, but that in the former the so-called TPP effect was low, indicating that uremia involved no thiamine deficiency.…”