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Medline ® Abstracts for References 5-7

of 'Uremic polyneuropathy'

5
TI
Uremic polyneuropathy: different effects of hemodialysis and continuous ambulatory peritoneal dialysis.
AU
Tegnér R, Lindholm B
SO
Acta Med Scand. 1985;218(4):409.
 
Registrations of clinical signs of neuropathy, quantified according to a fixed protocol, and determinations of vibratory perception thresholds and nerve conduction velocities (NCV) were performed in 22 patients treated with hemodialysis (HD) and in 21 patients treated with continuous ambulatory peritoneal dialysis (CAPD). Measurements were made at the start of dialysis and during a follow-up period of about 30 months. Motor NCV decreased in both groups; vibratory thresholds increased markedly in the CAPD patients, but not in the HD patients; and the clinical signs worsened in the HD patients, but not in the CAPD patients. The difference in outcome of the clinical signs during HD and CAPD was not of such a magnitude that one of these dialysis forms should be preferred before the other as regards neuropathy. We conclude that peripheral neuropathy may deteriorate during both HD and CAPD, but in significantly different ways, indicating that several pathogenetic mechanisms are probably involved in uremic neuropathy.
AD
PMID
6
TI
The effect of alterations of uremic retention products upon platelet and peripheral nerve function.
AU
Lindsay RM, Bolton CF, Clark WF, Linton AL
SO
Clin Nephrol. 1983;19(3):110.
 
Attempts at the identification of specific uremic toxins have, to date, been unrewarding and yet there is vogue for the measurement of, and the control by devices of hypothetical levels of, "middle molecular weight" toxins. In an attempt to elucidate whether small or middle molecular weight retention products are responsible for uremic platelet and peripheral nerve conduction defects, 14 patients with end-stage renal disease established on hemodialysis were studied using a conventional hemodialyzer and an experimental device which combined hemodialysis and hemoperfusion and which has enhanced in vitro vitamin B12 clearances. With the latter device reduced BUN and creatinine clearances were encountered and over a 2-month treatment period patient's serum BUN rose. In spite of this, there was improvement in the velocity of platelet aggregation to 10 microM adenosine diphosphate and to a standard collagen preparation associated with treatment by the experimental device. There was not, however, any demonstrable influence made on nerve conduction studies. The study suggests that different uremic retention products influence platelet and peripheral nerve function and that further efforts into studying the function of living cells or systems, in uremia might have better yield in the future guidance of the adequacy of dialysis than will the biochemical measurements of various waste products.
AD
PMID
7
TI
Nervous system disorders in dialysis patients.
AU
Bansal VK, Bansal S
SO
Handb Clin Neurol. 2014;119:395-404.
 
Neurologic complications are frequently encountered in dialysis patients. These may be due to the uremic state or to dialysis therapy, and require careful assessment. With longer survival of dialysis patients, these neurologic complications may significantly affect morbidity, mortality, and patients' well-being. Central nervous system involvement includes uremic encephalopathy as well as dialysis disequilibrium disorder. Both are rarely seen because of current improved understanding of their pathogenesis and treatment. Manifestations of atherosclerosis, stroke, and other neuropathies are present in this population and are not significantly altered by dialysis therapy. In recent years, increasing numbers of sleep disorders are being recognized. Peripheral nervous system involvement is also noted, including myopathy and related categories. In this chapter, we address clinical and pathophysiologic aspects of nervous system disorders in dialysis patients while discussing available therapeutic options to address the neurologic involvement.
AD
Division of Nephrology and Hypertension, Loyola University Medical Center, Maywood, IL, USA. Electronic address: vbansal@lumc.edu.
PMID