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Sural nerve morphology in asymptomatic uremia
R L Rosales1, J Navarro, S Izumo
1Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
European Neurology
|January 1, 1988
Summary
Structural changes in sural nerves occur in chronic kidney disease (CKD) patients even without clinical neuropathy. Early CKD may show myelin repair, while long-term disease indicates axonal degeneration, suggesting nerve changes precede symptoms.
Area of Science:
- Neurology
- Nephrology
- Pathology
Background:
- Uremia, a complication of chronic kidney disease (CKD), can affect nerve function.
- Clinical and electrophysiologic neuropathy are common in advanced uremia.
- Subtle nerve changes may exist before overt clinical manifestations.
Purpose of the Study:
- To investigate morphological changes in sural nerves of patients with acute and chronic uremia.
- To determine if structural nerve abnormalities precede clinical or electrophysiologic neuropathy in uremia.
Main Methods:
- Morphometric evaluation of sural nerve biopsies.
- Inclusion of patients with acute uremia (n=2) and chronic uremia (n=2).
- Exclusion of patients with clinical or electrophysiologic evidence of neuropathy.
Main Results:
- No significant abnormalities were found in the sural nerves of patients with acute uremia.
- Chronic uremia with shorter duration and dialysis showed morphometric changes indicating myelin repair.
- Chronic uremia with longer duration exhibited changes suggestive of axonal degeneration.
Conclusions:
- Sural nerve structural changes can occur in uremia before clinical or electrophysiologic neuropathy.
- Myelin repair and axonal degeneration are observed in chronic uremia, depending on disease duration.
- Morphological assessment is crucial for detecting early nerve damage in uremic patients.