Predictors of Peripheral Nerve Dysfunction in Young Renal Transplant Recipients: A Neurophysiological Study

[摘要] Background: Uremic neuropathy is one of the most debilitating symptoms associated with end stage renal disease. In adults the only potential cure for uremic neuropathy is renal transplantation. No studies have investigated the neurophysiologic abnormalities among pediatric renal transplant recipients. Objective: Our study aimed to describe the incidence, nature and factors affecting neurophysiological abnormalities in young renal transplant recipients. Methods: We studied 31 consecutive young patients who received live donor renal allografts. The neurophysiological studies were performed at different time points after transplantation (range 12-60 months), with a mean period of follow-up after transplantation 3.2±1.1 yr. Electromyography was carried out for: abductor pollicis brevis, biceps brachii, extensor digitorum brevis and rectus femoris muscles. The median and lateral popliteal nerves were tested for the motor conduction velocity. Results: A total of 31 live related young renal transplant recipients; 21 males and 10 females. The mean age at transplantation was 13.2±3.1 yr. Neuropathic changes were found in 19% of all cases with more affection of the distal muscles of lower limbs. Motor conduction velocities were reduced, distal latencies were lengthened, and motor unit action potentials were reduced or dispersed. The predictors for development of neuropathy by multivariate analysis were the cumulative steroid dose and acute rejection. The independent predictors for development of neuropathy were graft dysfunction and anemia. Conclusion: Neuropathy is prevalent among young renal transplants. Acute rejection episodes, graft dysfunction, cumulative steroid dose and anemia were significant predictors for development of neuropathy. [Egypt J Neurol Psychiat Neurosurg.  2010; 47(4): 611-616]

[学科分类] 精神健康和精神病学