Comparative study to evaluate the effects of peritoneal and hemodialysis on peripheral nerve function

Abstract

There is no specific treatment for neuropathy in chronic kidney disease (CKD). We compared nerve function across hemodialysis (HD) and peritoneal dialysis (PD). Subjects underwent neurological assessment and neurophysiological testing using nerve excitability studies. Pre- and postdialysis studies were undertaken in HD (n = 10) and PD (n = 10) patients and were compared with stage 4 CKD patients (n = 12) and healthy controls (n = 20). There were prominent differences in nerve excitability between the groups (P < 0.001). The HD group was significantly abnormal compared with all groups for excitability parameters, while the PD group demonstrated results similar to the CKD group. Pre- and postdialysis fluctuations were pronounced in the HD group, while the PD group showed less severe fluctuations. PD patients demonstrated greater normality of nerve excitability compared with the HD group despite similar duration of dialysis. These results suggest PD may provide greater homeostatic stability and may be neurologically beneficial. Muscle Nerve 54: 58-64, 2016.