말기 신질환 환자들에서 발생한 말초신경병증

Abstract

Objective: To investigate and analyze prevalence and characteristics of peripheral neuropathy in patients with end-stage renal disease (ESRD) according to the cause of ESRD. Methods: Cross sectional study was conducted in 112 patients who had undergone hemodialysis (n= 64) or peritoneal dialysis (n= 48). The medical records were reviewed. Standard motor and sensory nerve conduction studies, F waves, and H reflexes were performed. Peripheral neuropathy (PN) was diagnosed and classified into 4 grades. Results: PN was diagnosed in 58 patients (51.8%): 34 in hemodialysis (HD) group and 24 in peritoneal dialysis (PD) group. Forty two out of 47 patient with diabetes mellitus developed PN whereas 16 out of 65 did in non-diabetic patients (p<0.01). The severity of PN was as follows: Grade I, 12; Grade II, 11; Grade III, 26; Grade IV, 9. The duration of ESRD according to the severity of PN was not significant (p=0.056) in all the patients, but showed moderate correlation in non-diabetic patients (r=0.287, p<0.05). Conclusion: The diabetic patients may develop severe degree of PN compared to those with other etiology of ESRD because the peripheral nerve could be affected from both diabetes mellitus and uremia.