[Neuroelectrophysiological study in patients on long-term hemodialysis]

Uremic neuropathy is a common complication in patients on hemodialysis. Although there are still controversies over the pathogenesis of uremic neuropathy, neuroelectrophysiological study offers an objective and quantitative method of detecting this neuropathy, whether it is a question of axonal degeneration vs demyelination, sensory vs motor type, or distal vs proximal involvement. We also used the segmental latency of the median nerve to differentiate polyneuropathy from the carpal tunnel syndrome. Furthermore, this study also may serve as an important parameter for planning changes in different hemodialysis programs. Via the Medelec Mystro machine, we carried out an electrophysiological study of 38 hemodialysis patients. This study included motor and sensory nerve-conduction velocity studies and an H-reflex study of the tibial nerve. The incidence of polyneuropathy in patients on hemodialysis was 73.68%. Compared with normal controls, the velocity and amplitude of all tested nerves decreased significantly (P less than 0.01). The highest abnormal rate was the tibial nerve (73.7%). We found the severity of neuropathy did not closely correlate with the duration of hemodialysis (P greater than 0.05). Prolonged distal latency of the median motor and sensory nerves was about 50.0% and 31.6% respectively but prolonged segmental latency of the median sensory nerve was around 20% only. H-reflex of the tibial nerve was also significantly prolonged (P less than 0.01). We drew the following conclusions. First, polyneuropathy and carpal tunnel syndrome are common complications in patients on hemodialysis. Secondly, adequate hemodialysis can prevent the progression of uremic neuropathy. Thirdly, neuroelectrophysiological study may be used as one of the parameters for determining adequate hemodialysis.(ABSTRACT TRUNCATED AT 250 WORDS)