Said Gérard
Department of Neurology, Hôpital de la Salpêtrière, Paris, France.
Handb Clin Neurol. 2013;115:607-12. doi: 10.1016/B978-0-444-52902-2.00035-7.
Polyneuropathy is a common complication of end-stage renal failure especially when treatment with periodic hemodialysis is started too late. Large myelinated fibers bear the brunt of the many biological changes associated with renal failure. Nerve conduction slowing is common in this setting. Compression of the median nerve in the carpal tunnel commonly occurs in these patients, as a result of amyloid deposits at this site. End-stage renal failure in diabetic patients is often associated with severe distal motor and sensory deficits. Improved quality of periodic hemodialysis and renal transplantation have dramatically reduced the prevalence and severity of peripheral neuropathy in these patients.
多发性神经病是终末期肾衰竭的常见并发症,尤其是在开始定期血液透析治疗过晚时。粗大的有髓纤维首当其冲地受到与肾衰竭相关的许多生物学变化的影响。在这种情况下,神经传导减慢很常见。由于该部位有淀粉样沉积物,这些患者常发生腕管内正中神经受压。糖尿病患者的终末期肾衰竭常伴有严重的远端运动和感觉功能障碍。定期血液透析质量的提高和肾移植显著降低了这些患者周围神经病变的患病率和严重程度。