Cortical excitability and central conductivity in chronic renal failure patients maintained on hemodialysis

Abstract EN

Objectives : The aim of this work was to ascertain central nervous system dysfunction in chronic renal failure patients maintained on hem dialysis.

Subjects : Thirty chronic renal failure (CRF) patients maintained on regular hem dialysis (aged 23-59 years )without any peripheral and / or central neurological or psychiatric disorders).

A group of 30 apparently healthy individuals of matching age served as a control group.

Methodology : Patients and controls were subjected to the following: (1) Peripheral sensory and motor conduction studies.

(2) Percutaneous transcranial magnetic stimulation over the corresponding motor cortex of the lower limb.

(3) Determination of cortical silent period.

(4) Spinal and cortical mixed nerve somatosensory evoked potentials.

(5) Determining serum creatinine, blood urea nitrogen, hemoglobin, hematocrit level, sodium, calcium and potassium plasma ions level.

Results : There was no significant difference between patients and controls regarding peripheral conduction studies.

Patients with CRF showed an increase of motor threshold, prolongation of central sensory conduction time, central motor conduction time and cortical silent period as well as reduction of motor evoked potential amplitude when compared with age matched control subjects.

Conclusions: CRF patients maintained on hem dialysis have lower cortical excitability and corticospinal conductivity than normal even in the absence of peripheral nervous system abnormalities.