Sensory perception in uremic patients

Peripheral (PNS) and central (CNS) sensory nervous system function was quantitatively assessed using neuroselective transcutaneous electrical nerve stimulation (TENS) in a population of 19 chronic hemodialysis patients (ages 17-77, median 47 years; duration 1-14, median 3 years). Cutaneous current perception threshold (CPT) provided an index of PNS integrity, and a new technique involving cranial TENS to characterize cephalic evoked noncutaneous sensations (CENS) was used to assess CNS sensory function. Patients showed both CPT (32%) and CENS (89%) abnormalities as compared with previously tested healthy subjects. No significant correlation was observed between age, duration of dialysis, PNS, and CNS abnormalities. The CPT examination provides a sensitive and easy to administer test of PNS sensory function for the purpose of assessing the adequacy of dialysis in chronic hemodialysis patients; the CENS examination also may prove useful in this regard.