ABSTRACT
BACKGROUND: The efficacy of dialysis on the autonomic and peripheral nerve function has been a subject of considerable debate. In addition, no longitudinal study on the course of uremic neuropathy in end-stage renal disease (ESRD) during dialysis has been reported. We carried out a prospective study to investigate the effect of dialysis on the autonomic and peripheral nerve function during the first 12 months of dialysis. METHODS: Twenty-five patients with ESRD (14 on HD and 11 on CAPD; 11 diabetic and 14 non- diabetic) were enrolled. Autonomic nerve function test and median nerve conduction velocity study were done at the initiation of dialysis and then repeated after 12 months of dialysis. RESULTS: At the initiation of dialysis, sympathetic nerve function and parasympathetic nerve function were abnormal in all HD and CAPD patients. After 12 months of dialysis, no significant changes occurred in autonomic function test. There was no significant difference in autonomic function test between HD and CAPD patients. There was no significant difference in median nerve conduction velocity between HD and CAPD patients after 12 months of dialysis. At the initiation of dialysis, 6 of 11 diabetic and 4 of 14 non-diabetic patients had abnormal median nerve conduction velocity. After 12 months of dialysis, normalization of median nerve conduction velocity occurred only in 3 non-diabetic patients. There was a singinficant difference in median nerve conduction velocity between diabetic and non-diabetic patients after 12 months of dialysis. CONCLUSION: We conclude that dialysis does not significantly alter the autonomic nerve function during the first 12 months of dialysis, but may improve the peripheral nerve function in non-diabetic uremic patients.