Guihéneuc P
Laboratoire des explorations fonctionnelles, CHU-Hôtel Dieu, Nantes.
Nephrologie. 1997;18(5):165-73.
Described at the end of the 19th century, investigated from the development of dialysis since 1960, peripheral neuropathy occurs almost constantly in patients with a pre-dialytic renal failure. Clinical signs are mainly sensory ones Severe nerve deficiencies are rarely found. Electrophysiological techniques are performed to quantify the demyelinating and axonal lesions, to verify the long term adequacy of dialysis, and to observe improvement after kidney transplantation. Diabetes and vascular lesions can induce important axonal damage. Nerve entrapments (Median nerve in the carpal tunnel) are frequent and may worsen in a few months. Factors involved in the development of peripheral neuropathy in uremic patients remain partly unknown.
外周神经病变在19世纪末被描述,自1960年透析技术发展以来受到研究,几乎所有透析前肾衰竭患者都会出现外周神经病变。临床症状主要为感觉症状,严重的神经功能缺陷很少见。采用电生理技术来量化脱髓鞘和轴突损伤,验证透析的长期充分性,并观察肾移植后的改善情况。糖尿病和血管病变可导致严重的轴突损伤。神经卡压(腕管综合征中的正中神经)很常见,可能在几个月内恶化。尿毒症患者外周神经病变的发病因素仍部分不明。