Peripheral nerve function in children with end-stage renal failure.

Abstract

Information on clinical and subclinical peripheral neuropathy in children with end-stage renal failure (ESRF) is scarce. We have studied the presence of clinical and subclinical peripheral neuropathy in children with ESRF comparing recently developed non-invasive methods with the measurement of nerve conduction velocities. Twelve children (7 boys, 5 girls; age range: 5-17 years; duration of haemodialysis: 0.5-60 months) participated. Thermal discrimination threshold (TDT) and vibration perception threshold (VPT) were determined twice before and after haemodialysis in each patient. Peroneal nerve conduction velocity was determined once before haemodialysis. No clinical or subclinical peripheral neuropathy was observed in any of the children. Except for two slightly increased TDT values after haemodialysis all results were within the normal range. No correlation was found with age or duration of haemodialysis and no association was found between the three methods. VPT values showed a significant improvement after haemodialysis treatment, although all VPT values were in the normal range. This suggests that haemodialysis has an influence on cutaneous sensation, but further study is needed to confirm this observation. Longitudinal investigations will be necessary to evaluate whether TDT and VPT determinations can be used for early screening of clinical and subclinical neuropathy in children with ESRF.