The Progression of Uremic Polyneuropathy in Patients on Hemodialysis and Hemofiltration: A Two-Year Study

Abstract

U remic polyneuropathy is one of the major complications of long-term end-stage renal disease. In the present study, we performed an electrophysiologic evaluation in 17 patients having a mean age of 49 ± 11 years. The patients were divided into two groups according to dialysis method. Group A included 9 patients who were undergoing conventional hemodialysis (mean age, 44.2 ± 12.5 years; mean duration on dialysis, 21.7 ± 4.3 months); group B included 8 patients undergoing hemofiltration (mean age, 55.2 ± 5.2 years; mean duration on treatment, 27 ± 7.6 months). Measurements of the distal latency time of the sensory fibers (median, ulnar, and sural nerves), and measurements of the distal latency time and peripheral conduction velocity of the motor fibers (median and peroneal nerves) were performed. In addition, we recorded somatosensory evoked potentials after peripheral stimulation of the median and peroneal nerves. The electrophysiologic evaluations were repeated two times at intervals of 12 months.In group A, a statistically significant worsening of motor and sensory conductance in the upper and lower limbs was observed; in group B, a statistically significant improvement was found. These findings suggest that hemofiltration has a more beneficial effect on motor and sensory conductivity than does conventional hemodialysis.

We Should Strive for Optimal Hemodialysis: A Criticism of the Hemodialysis Adequacy Concept

“…Renal replacement therapy that effectively removes these molecules by convective transport (hemofiltration) improves peripheral neuropathy better than conventional hemodialysis (4-hour, thrice weekly) which has lower MM clearances and higher clearances of small molecules [51]. A recent comparison of convective and diffusive therapy again confirmed the benefits of convective transport.…”