ABSTRACT
Objective and aim of the work: uremic syndrome is characterized by overall deterioration of biochemical and physiological functions in parallel with progression of renal failure. Uremic polyneuropathy represent a well- known complication of end-stage renal failure [ESRF] caused by major neurotoxins accumulating in uremia, such as urea, creatinine, uric acid, middle molecules and others. The study was performed to study the effect of daily hemodialysis on uremic polyneuropathy and improving the patients clinically and biochemically. The cases of this study were patients under regular hemodialysis in the Nephrology Unit, Medical Department, Al-Azhar University and Naser City Hospitals from October 2004 to Mayo 2005. Material and methods: the cases of this study were patients under regular hemodialysis in the Nephrology Unit, Medical Department, Al-Azhar University and Nasr City Hospitals. The patients classified into 2 groups: group 1 comprised 10 patients with ESRF under thrice-weekly hemodialysis for less than 3 years; group ii comprised 10 patiepts with ESRF under thrice-weekly hemodialysis for less than 3 years who shift to daily hemodialysis except Fridays for 6 months; and 10 healthy normal volunteers of matching age and sex were the control group. Complete clinical and laboratory instigation were performed with nerve conduction velocity [sensory] and distal latency [motor] for median, ulnar and common peroneal nerves. K [t/v] to assess the adequacy of hemodialysis. paraethesia showed significant differences after 6 months of daily dialysis [p < 0.001], while other neurological symptoms and signs showed no significant differences in both groups after 6 months of dialysis. Sensory and motor nerve conduction study was significantly impaired in the median, ulnar and common peroneal in both groups when compared to controls [p < 0.001]. Nerve conduction velocities [sensory] were significantly improved in three nerves after 6 months of daily dialysis [p < 0.01], on the other hand no significant improvement was noticed after 6 months of thrice-weekly dialysis. Distal motor latency [motor] showed no significant improvement in three nerves in both groups after 6 months of dialysis. K [t/v] value was not significantly improved after 6 months of daily dialysis [3.2 vs. 3.1, p = 0.521]. from our study we speculated that the protocol of daily hemodialysis is feasible in routine hospital practice being well tolerated by patients and having a low incidence of complications compared to the standard protocol. Further works are required to study the effect of daily home dialysis on the different clinical, biochemical and psychological aspects of dialysis patients as well as the economic aspects of the daily regimen hemodialysis