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PRESERVATION OF PERIPHERAL NERVE FUNCTION IN SEVERE UREMIA DURING TREATMENT WITH LOW PROTEIN HIGH CALORIE DIET AND SURPLUS OF ESSENTIAL AMINO ACIDS
Author(s) -
Bergström J.,
Lindblom U.,
Norée L. O.
Publication year - 1975
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1975.tb01363.x
Subject(s) - uremia , peripheral neuropathy , medicine , creatinine , renal function , malnutrition , endocrinology , surgery , gastroenterology , diabetes mellitus
Twelve patients with severe chronic renal failure (serum creatinine 7.0–27 mg %), and marked uremic symptoms on a 40 g protein diet, were treated with a caloric‐rich diet containing 16–20 g protein, supplemented with the 8 essential amino acids (1.1–2.2 g N) and histidine (0.23–0.45 g N) in the form of tablets for periods between 3 and 34 months. During the treatment the serum urea‐N fell, and the uremic symptoms subsided or diminished without the patients exhibiting signs of malnutrition. The nerve function was followed with quantitative and semiquantitative neurological tests (among others, determination of vibratory perception thresholds and nerve conduction times). Initially all patients but 2 had signs of neuropathy as measured by these methods. During the course of treatment no deterioration of peripheral nerve function was recorded in any of the patients, several of whom had had serum creatinine concentrations above 15 mg % for long periods. We conclude that conservative treatment with N‐poor diet in far advanced chronic renal failure may prevent the further development of peripheral neuropathy provided that adequate calories and essential amino acids (2–3 × the minimal requirements) are supplied. The results suggest that, in addition to uremic toxines, malnutrition is a factor of importance for the developments of uremic neuropathy.