Improvement of autonomic neuropathy after mecobalamin treatment in uremic patients on hemodialysis.

The effect of mecobalamin on autonomic neuropathy was evaluated in 20 hemodialyzed uremic patients; their mean age was 53 years and the duration of hemodialysis was 6.5 years; 14 were women. The cardiac beat-to-beat variation (BBV) was used as the measure of autonomic neuropathy. Twelve patients with normal BBV test results were either given 1,500 micrograms of mecobalamin daily for three months (six patients) or were untreated (six patients). The BBV test results did not change significantly over the three months in either the treated or untreated group, nor were there any significant between-group differences. Eight patients with abnormal results on the BBV test were given 1,500 micrograms of mecobalamin daily for six months. The mean BBV values increased significantly from 3.3 beats/min before treatment to 5.8 beats/min at six months (P less than 0.005); five of these patients (including three of the four patients with diabetes) showed normal BBV values by three months. It is concluded that mecobalamin can be used in the treatment of autonomic and peripheral neuropathy in both diabetic and nondiabetic patients with chronic renal failure.