THE PERIPHERAL NERVE FUNCTION IN CHRONIC RENAL FAILURE

Abstract

AbstractThe vibratory perception threshold (VPT) has been determined in 85 normal persons and 97 patients with chronic renal failure. In normal persons VPT was an exponential function of age. The rate of elevation was faster on the lower than on the upper extremity and faster in males than in females. In the patient group as a whole the average deviation from the normal mean VPT, adjusted for age and sex, was significantly elevated in the upper and lower extremities. Male patients were significantly more affected than female patients. In females no correlation was present with kidney function and/or age. In males the vibratory perception deteriorated significantly with advancing renal failure, and for comparable degree of renal failure the vibratory perception was more severely affected in old than in young patients. The vibratory perception was more affected on the lower than on the upper extremity and on distal than on proximal test spots. The degree of impairment was roughly correlated with the severity of clinical neuropathy. A significant correlation with the motor conduction velocity (Vm) in the peroneal nerve could be referred to a joint covariation with the kidney function. In the median nerve no correlation was present between VPT and electrophysiological data from sensory nerve conduction studies. Like other clinical components of peripheral neuropathy the diagnostic significance of VPT as an indicator of peripheral nerve dysfunction could be characterized by high specificity and low sensitivity. However, VPT is a quantitative measure and readily applicable for bedside examination, which may prove to be of particular value in longitudinal studies.