PERIPHERAL NEUROPATHY IN PATIENTS WITH CHRONIC-RENAL-FAILURE - A TREATABLE SOURCE OF DISCOMFORT AND DISABILITY

Uremic polyneuropathy occurs in about half of patients undergoing dial ysis and is characterized by axonal degeneration with secondary segmen tal demyelination. Hemodialysis or peritoneal dialysis halts the progr ess of polyneuropathy but usually does not bring improvement. However, improvement invariably occurs with successful renal transplantation. Mononeuropathies resulting from placement of forearm arteriovenous fis tulas are also seen and include the commonly encountered carpal tunnel syndrome and the rare but catastrophic ischemic monomelic neuropathy. The latter constitutes a medical emergency; immediate surgical closur e of the fistula is required to avoid severe and permanent neurologic dysfunction.