慢性腎不全のulnar nerve excitability

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タイトル別名
  • ULNAR NERVE EXCITABILITY IN CHRONIC RENAL FAILURE
  • マンセイ ジンフゼン ノ ulnar nerve excitability

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Peripheral nerve dysfunction is one of the most common symptoms in uremia and its degree has been in use as an indicator of well-being in regular dialysis treatment patients. In search of a preciser approach to the identification and the management of uremic neuropathy, the Heckmann's technique for the measurement of nerve excitability has been used to study patients with chronic renal failure. Degree of peripheral nerve dysfunction was determined on the basis of hypoexcitability. Experimental materials were 23 patients with chronic renal failure; 21 untreated patients whose creatinine clearance were under 50 ml/min (A-group), 2 patients with conservative treatment whose creatinine clearance were under 10 ml/min (B-group). In A-group, ulnar nerve excitability (UNE) of patients over 20 ml/min of creatinine clearance was normal and they showed little symptoms of uremia. In the patients under 20 ml/min, UNE decreased and they definitely showed uremic symptoms. Moreover, in the patients under 10 ml/min, dialysis treatment was almost always necessary, since the UNE and uremic symptoms were not improved with conservative treatment. On the other hand, in the patients under 10 ml/min of creatinine clearance in B-group who had been doing favorably with conservative treatment, did not show hypoexcitability or uremic symptoms. From these data on UNE, it can be concluded that a relationship exists between the lowering of UNE and residuary nephron and that the improvement of UNE and uremic symptoms is poss sible with conservative treatment only. Thus, we suggest that the measurement of UNE will be useful as an indicator of inducing patients with chronic renal failure to dialysis treatment, and as a judgment of effects of dialysis treatment.

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