Peripheral neuropathy is frequently associated with chronic renal insufficiency. It presents as progressive peripheral involvement first of sensory, then motor fibers. Loss of vibration sense is the most consistent early finding. Nerve conduction measurements aid in the detection of mild or subclinical neuropathy. Patients on long-term dialysis therapy also have neuropathy as evidenced by slowed nerve conduction. Allowing patients to become critically ill with uremia and its complications may predispose them to rapidly progressive motor neuropathy during the early phase of dialysis therapy. Since motor neuropathy may not be reversible, every effort should be made to avoid this complication by instituting dialysis therapy before severe uremia develops. Adequate dialysis appears to arrest the progression of neuropathy, and is followed by slow improvement over months or years. Successful renal transplantation greatly improved nerve function in two patients.
Tenckhoff HA, Boen FST, Jebsen RH, Spiegler JH. Polyneuropathy in Chronic Renal Insufficiency. JAMA. 1965;192(13):1121–1124. doi:10.1001/jama.1965.03080260009003
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