Peripheral nerve function is frequently altered in CRF although clinical manifestations in children are rare. For assessment of uremic neuropathy the measurement of motor nerve conduction velocity (MNCV) has widely been used. In an earlier study we failed to find a correlation between MNCV and severity of CRF. In the present study a more sensitive neurographic parameter has been applied: the relative refractory period as estimated by neuromuscular reaction to paired stimuli (NMRPS). This method was tested in 24 children with CRF on conservative treatment(CT), 11 pts immediately before and after a haemodialysis(HD) session and 13 pts after transplantation(TP). In CT a correlation was found between some parameters of NMRPS and serum creatinine(SCR). The changes of NMRPS correlated even better with those of SCR during a HD session. After TP a significant improvement of MNCV was observed whereas NMRPS was unchanged. These data suggest that 1) NMRPS is a sensitive parameter of uremic neuropathy which might be used to control adequacy of therapy, 2) short term improvement of neuroaxonal function occurs by HD, 3) long-term improvement of myelin sheeth function is induced after TP.
展开▼
