Initial observations in adults revealed that peripheral neuropathy, as documented by reduced conduction velocity is common L chronic renal failure. Critical analysis of this problem in children on long-term dialysis is scarce, consisting of a single report which demonstrated that the motor nerve conduction velocities were decreased early and frequently with more severe depression in peroneal nerve velocities. This is in distinct contrast to data from adults, in whom uniform rates of deterioration are encountered. In addition, a direct correlation of the degree of nerve conduction defect with the severity of the renal failure is found in adult patients.Summary
The present study showed a relative lack of nerve conduction defects in 11 children on long-term hemodialysis. With rare exceptions, the conduction velocities were normal. To date, no clinical symptoms of neuropathy were evident in our patients. It would seem that, with the short-dialysis schedule of 12–14 h/wk over a period of up to 5 yr, there is no progressive neuropathy as quantitated by nerve conduction measurements.Speculation
Nutritional augmentation, treatment with 1,25-vitamin D3, suppression of parathormone and other as yet undefined age-specific factors may be responsible for the prevention of peripheral neuropathy in these children, as compared to the high incidence in adults receiving similar dialysis treatment.