Disturbances of peripheral and autonomic nervous system in chronic renal failure: effects of hemodialysis and transplantation.

Investigations of peripheral and autonomic nervous system functions were performed in 37 healthy persons, 66 patients with chronic renal failure (31 undialyzed patients, 35 dialyzed patients) and in 18 transplanted patients. The study resulted in disturbances of nerve conduction velocity and pallesthesia in predialysis and hemodialysis patients. After the transplantation, an amelioration of peripheral nerve function was observed. A set of autonomic tests demonstrated vagally mediated disorders in the predialysis group. The sympathetic function was hardly affected. In dialysis group as well as in transplanted patients a significant improvement of parasympathetic dysfunction was observed. We conclude that disorders to the autonomic nervous system in chronic renal failure are characterized by reversible vagal changes, while disorders of peripheral nervous system are resistant to hemodialysis therapy.