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Peripheral nerve function in children with end-stage renal failure
C E de Beaufort1, J L André, J J Heimans
1Department of Paediatrics I, CHU Brabois, Nancy, France.
Insights
No clinical or subclinical peripheral neuropathy was found in children with end-stage renal failure (ESRF). However, haemodialysis may influence cutaneous sensation, warranting further investigation for early neuropathy screening.
Area of Science:
- Pediatric Nephrology
- Neurology
Background:
- Peripheral neuropathy is a potential complication in children with end-stage renal failure (ESRF).
- Limited data exists on the prevalence and detection of neuropathy in this pediatric population.
Purpose of the Study:
- To investigate clinical and subclinical peripheral neuropathy in children with ESRF.
- To compare non-invasive sensory testing (thermal discrimination threshold [TDT] and vibration perception threshold [VPT]) with nerve conduction velocity (NCV) measurements.
Main Methods:
- Twelve children undergoing haemodialysis for ESRF were assessed.
- TDT and VPT were measured twice before and after haemodialysis.
- Peroneal nerve conduction velocity was measured once before haemodialysis.
Main Results:
- No clinical or subclinical peripheral neuropathy was detected in any participant.
- Most TDT and VPT results were within normal limits, with minor post-haemodialysis TDT elevations in two children.
- No significant correlation was found between neuropathy indicators, age, or haemodialysis duration.
- VPT showed a significant improvement post-haemodialysis, despite normal baseline values.
Conclusions:
- Current non-invasive methods did not reveal neuropathy in pediatric ESRF patients.
- Haemodialysis appears to influence cutaneous sensation, suggesting potential benefits.
- Longitudinal studies are needed to validate TDT and VPT for early neuropathy screening in pediatric ESRF.
Abstract:
Information on clinical and subclinical peripheral neuropathy in children with end-stage renal failure (ESRF) is scarce. We have studied the presence of clinical and subclinical peripheral neuropathy in children with ESRF comparing recently developed non-invasive methods with the measurement of nerve conduction velocities. Twelve children (7 boys, 5 girls; age range: 5-17 years; duration of haemodialysis: 0.5-60 months) participated. Thermal discrimination threshold (TDT) and vibration perception threshold (VPT) were determined twice before and after haemodialysis in each patient. Peroneal nerve conduction velocity was determined once before haemodialysis. No clinical or subclinical peripheral neuropathy was observed in any of the children. Except for two slightly increased TDT values after haemodialysis all results were within the normal range. No correlation was found with age or duration of haemodialysis and no association was found between the three methods. VPT values showed a significant improvement after haemodialysis treatment, although all VPT values were in the normal range. This suggests that haemodialysis has an influence on cutaneous sensation, but further study is needed to confirm this observation. Longitudinal investigations will be necessary to evaluate whether TDT and VPT determinations can be used for early screening of clinical and subclinical neuropathy in children with ESRF.