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Inflammatory demyelinating neuropathy in patients with end-stage renal disease receiving continuous ambulatory
Objective:
To report on 3 patients with inflammatory demyelinating peripheral neuropathy in strong temporal coincidence with the initiation of peritoneal dialysis (PD) therapy.
Setting:
Nephrology and Neurology Department of the University Hospital, Munich, Germany.
Patients:
Three patients with end-stage renal failure presented with the clinical picture of inflammatory demyelinating peripheral neuropathy within 4 to 10 weeks after start of continuous ambulatory peritoneal dialysis (CAPD). They had acute or subacute onset of lower extremity or generalized weakness, diminished reflexes, elevated spinal fluid protein levels, and signs of demyelinating neuropathy on electrophysiological testing.
Measures:
Clinical follow-up, nerve conduction studies, cerebral spinal fluid (CSF).
Results:
All patients did not improve under intensified PD therapy but took profit from immunomodulatory therapy. One bed-bound patient improved after change to hemodialysis and showed complete remission after renal transplantation.
Conclusion:
Because of strong temporal coincidence, a causal relationship between CAPD and inflammatory demyelinating peripheral neuropathies can be suspected in these 3 patients.