Intravenous methylcobalamin treatment for uremic and diabetic neuropathy in chronic hemodialysis patients

Object: To study the effects of the intravenous administration of methylcob alamin, an analogue of vitamin B-12, for uremic or uremic-diabetic polyneur opathy in patients who are receiving maintenance hemodialysis. An ultra-hig h dose of vitamin B-12 has been reported to promote peripheral nerve regene ration in experimental neuropathy, Methods: Nine patients received a 500 mu g methylcobalamin injection 3 times a week for 6 months. The effects were evaluated using neuropathic pain grading and a nerve conduction study. Resu lts: Serum concentrations of vitamin B-12 were ultra-high during treatment due to the lack of urinary excretion. After 6 months of treatment, the pati ents' pain or paresthesia had lessened, and the ulnar motor and median sens ory nerve conduction velocities showed significant improvement. There were no side effects. Conclusion: Intravenous methycobalamin treatment is a safe and potentially beneficial therapy for neuropathy in chronic hemodialysis patients.