The Peripheral Nerve Function in Chronic Renal Failure

Sensory and motor nerve conduction parameters have been studied before and after a successful renal transplantation in 22 patients, 13 of whom had moderate to severe clinical neuropathy. The observation period ranged from 5 weeks to 31 months. The earliest postoperative examination was made after 6.2 + 0.8 weeks, and 10 patients were studied for more than two years. Before transplantation a general slowing of the nerve conduction was present. After transplantation the conduction velocity increased in all patients. The remission was two‐phasic with an early rapid and a late slow phase. The recovery was more rapid and complete in distal than in proximal segments, where the conduction velocity was still significantly slowed after two years. Sensory action potentials (median nerve) became resynchronized and the amplitude was normal after 6 (wrist) and 12 months (elbow). Signs of reinnervation of distal muscles were observed after one month. The amplitude of muscle action potentials increased and in most patients the electro‐myogram at maximal effort became normal, though in severely affected muscles the recovery was incomplete or absent. The uniform degree of impairment and the pattern of recovery in distal and proximal nerve segments appeared incompatible with an ascending segmental de‐myelination and axonal degeneration as the only pathophysiological factor of uremic neuropathy.