The Usefulness of Sympathetic Skin Response in Patients with Chronic Renal Failure

ABSTRACT

OBJECTIVE: The sympathetic skin response (SSR) was measured in patients with chronic renal failure (CRF) for diagnosis of uremic polyneuropathy and its correlations with nerve conduction study (NCS) and clinical autonomic symptoms were investigated. METHOD: The SSR was measured in 15 patients with CRF on regular hemodialysis, aged 26 to 67 years. With median nerve stimulation at the wrist using the extremity without arteriovenous fistula, the SSR was recorded from both palm and sole simultaneously. The responses were interpreted as normal (presence) or abnormal (absence). Routine nerve conduction study was also performed in the same extremities and clinical autonomic symptoms were investigated. RESULTS: Nine of fifteen patients (60.0%) had symptoms suggestive of autonomic dysfunction the most frequent findings were orthostatic dizziness and sweating problem. The SSR was absent in four of fifteen patients (26.7%). There is no significant relationship between SSR and autonomic symptoms (P>0.05). The nerve conduction study was abnormal in eight of fifteen patients (53.3%), and the SSR was absent in two of seven patients with normal NCS. There is no significant relationship between NCS and SSR (P>0.05). CONCLUSION: Although the proportion of abnormal SSR was small, it may be a valuable method in the assessment of uremic polyneuropathy in conjunction with routine nerve conduction study in CRF patients.