INFLAMMATORY DEMYELINATING NEUROPATHY IN PATIENTS WITH END-STAGE RENAL-DISEASE RECEIVING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS (CAPD)

Objective: To report on 3 patients with inflammatory demyelinating per ipheral neuropathy in strong temporal coincidence with the initiation of peritoneal dialysis (PD) therapy. Setting: Nephrology and Neurology Department of the University Hospital, Munich, Germany. Patients: Thr ee patients with end-stage renal failure presented with the clinical p icture of inflammatory demyelinating peripheral neuropathy within 4 to 10 weeks after start of continuous ambulatory peritoneal dialysis (CA PD). They had acute or subacute onset of lower extremity or generalize d weakness, diminished reflexes, elevated spinal fluid protein levels, and signs of demyelinating neuropathy on electrophysiological testing . Measures: Clinical follow-up, nerve conduction studies, cerebral spi nal fluid (CSF). Results: All patients did not improve under intensifi ed PD therapy but took profit from immunomodulatory therapy. One bed-b ound patient improved after change to hemodialysis and showed complete remission after renal transplantation. Conclusion: Because of strong temporal coincidence, a causal relationship between CAPD and inflammat ory demyelinating peripheral neuropathies can be suspected in these 3 patients.