Neuropathy in end-stage renal disease secondary to primary renal disease and diabetes

A study was undertaken to critically observe electrophysiologic findings in patients with end-stage renal disease (ESRD) secondary to primary renal disease (PRD) and to compare these with data recorded from patients with ESRD secondary to diabetes mellitus. Motor and sensory nerve conduction velocity studies were performed on 56 patients; 16 parameters were investigated and laboratory data recorded. Our findings reveal that diabetic uremics have more severe peripheral neuropathy electrophysiologically than nondiabetics, indicating that the diabetic component of neuropathy sustains its influence even in the presence of end-stage renal neuropathy. The sural latency and amplitude, median sensory latency and amplitude, H-reflex and facial latency were significantly involved parameters in nondiabetic and diabetic patients. The facial nerve was found to be a sensitive indicator of uremic neuropathy. In 28 nondiabetic uremic patients the mean facial latency was 3.8 +/- 0.5msec compared to 28 diabetic uremic patients with a mean of 5.0 +/- 0.4msec.