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      Sympathetic Skin Response in Hemodialysis Patients: Correlation with Nerve Conduction Studies and Adequacy of Dialysis

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          Abstract

          A sympathetic skin response (SSR) test was performed in diabetic and nondiabetic patients undergoing regular hemodialysis and the results correlated with nerve conduction studies (NCS): sensory conduction velocity (SCV) and motor conduction velocity (MCV). Comparisons were made between diabetic and nondiabetic patients and between cuprophane and polyacrylonitrile membrane dialyzed patients. Six nondiabetic uremic patients (30%) and all diabetic patients had no SSR. Eight nondiabetic uremic patients (40%) had a mildly impaired response. Nondiabetic patients with a normal response were younger (31.1 ± 16.4 years) than the patients with abnormal SSR, whether mildly impaired response (58.3 ± 20.3 years; p < 0.05, Anova) or absent response (65.3 ± 13.8 years; p < 0.01, Anova). SCV, MCV, and SSR values were reduced (p < 0.01) in uremic patients with respect to normal subjects. Severity and frequencies of sensory NCS abnormalities in nondiabetic patients were: normal 20%, mildly impaired 75%, and severely impaired 5%. Severity and frequencies of motor conduction abnormalities were: normal 80%, mildly impaired 20%, severely impaired 0%. The SSR abnormality incidence in patients with a normal NCS was similar to that in patients with either mildly or severely impaired NCS (chi-square test). There was a positive linear correlation between the SSR amplitude and SCV (r = 0.52, p < 0.01) and MCV (r = 0.49, p < 0.01). The SSR latency was also significantly related to SCV (r = 0.66, p < 0.01) and MCV (r = 0.61, p < 0.01). A significant negative correlation was found between age and SSR parameters, amplitude (r = –0.56, p < 0.01) and latency (r = –0.66, p < 0.01). No correlation was found between duration of hemodialysis or Kt/V and SSR. No differences were found in SSR, NCS, or Kt/V values between cuprophane membrane and polyacrylonitrile membrane dialyzed patients (Student’s t test). The relationship between NCS and SSR in uremic patients was confirmed. Old age and diabetes mellitus, but not the dialysisis membrane used, were confirmed as synergistic factors of neuropathic impairment. It appeared that SSR is more sensitive than NCS in detecting polyneuropathy in uremic patients on hemodialysis.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1999
          May 1999
          28 April 1999
          : 82
          : 1
          : 12-16
          Affiliations
          Secciones de aNefrología y bNeurofisiología, Hospital Regional ‘Infanta Cristina’, Badajoz, Spain
          Article
          45361 Nephron 1999;82:12–16
          10.1159/000045361
          10224478
          © 1999 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 2, Tables: 3, References: 14, Pages: 5
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/45361
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Polyneuropathy, Chronic renal failure, Hemodialysis

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