Accelerated neuropathy of renal failure.
Accelerated neuropathy of renal failure.
复制标题
肾衰竭的加速神经病变。
DOI：
10.1001/archneur.1993.00540050078020
复制
发表时间：
1993
影响因子：
--
通讯作者：
A. Ropper
中科院分区：
文献类型：
--
作者：
A. Ropper
目的
描述严重肾功能衰竭患者快速发展的多发性神经病综合征。
设计
4例患者的回顾性病例系列。
设置
住院评估和患者个人检查。
患者
4例接受腹膜透析的重度或终末期肾衰竭患者。
结果
这些患者具有急性或亚急性综合征，其特征为全身肢体无力持续数天或数周，严重失衡，反射减弱和麻木。脊髓液蛋白水平升高，电生理检查发现一些脱髓鞘特征。在一名患者中，更频繁的腹膜透析和另一名患者的移植改善了病情，但在另外两名患者中，糖尿病可能发挥了作用。
结论
这种部分可逆的急性尿毒症神经病变可能由终末期肾衰竭的代谢紊乱引起，类似于格林-巴利综合征或慢性炎性脱髓鞘性多发性神经病变，可能并发糖尿病神经病变。
OBJECTIVE
To describe a syndrome of rapidly evolving polyneuropathy in patients with severe renal failure.
DESIGN
Retrospective case series of four patients.
SETTING
In-hospital evaluations and personal examinations of patients.
PATIENTS
Four patients with severe or end-stage renal failure who were receiving peritoneal dialysis.
RESULTS
These patients had an acute or subacute syndrome characterized by generalized limb weakness over days or weeks, severe imbalance, diminished reflexes, and numbness. Spinal fluid protein levels were elevated and some demyelinating features were noted on electrophysiological testing. Improvement occurred with more frequent peritoneal dialysis in one patient and transplantation in another, but the neuropathy progressed in the other two in whom diabetes may have played a role.
CONCLUSION
This partly reversible acute uremic neuropathy, which is probably caused by the metabolic disturbances of end-stage renal failure, simulates Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy and may be complicated by diabetic neuropathy.