Nervous impulse propagation along peripheral and central fibres in patients with chronic renal failure

In thirty-one patients with chronic renal failure we measured the conduction velocities in the proximal regions of median and peroneal nerves and concurrently evaluated the propagation properties of an afferent input along the related central (spinal and supraspinal) sensory pathways. In 26 of these patients the sensorimotor velocities of median, peroneal and sural nerves were also calculated. Lower limb peripheral conduction was more frequently abnormal than that of upper limb, the distal segment being involved to a greater degree. Since central propagation was more impaired during lower (11 out of 27 cases) than during upper limb (1 out of 27 patients) stimulation and the intracranial propagation time was rarely prolonged, a predominantly spinal defective impulse conduction was hypothesized. Neurophysiological data seem to confirm that early stages of defective neural conduction in CRF are in agreement with the model of central-peripheral distal axonopathy. However, an abnormal impulse propagation was also rarely found in proximal districts of peripheral fibres as well as along the intracranial sensory pathways. Correlations were found between some of the impulse propagation properties and the duration of CRF or dialysis. Serum parathyroid hormone, creatinine and BUN levels were correlated with some peripheral and central conduction indexes.