This study was conducted to observe complications of the nervous system in chronic renal failure (CRF) and to observe the time of recovery of the nervous complications after successful renal transplantation. Median nerve somatosensory evoked
potentials
(MN-SEP), tibial nerve somatosensory evoked potentials (TN-SEP), brainstem auditory evoked potentials (BAEP0 and visual evoked potentials (VEP) were recorded by using a Medelec ST 10 Sensor EP apparatus before renal transplantation and
subsequently
2, 4
and 12 weeks after renal transplantation in 40 CRF patients (32 men and 8 women). Results were then compared with normal data from age, sex and these changes were compared with the alterations of multimodal EP.
In pre-renal transplantation states, the values of all of the absolute latencies and most of the interpeak latencies of MN-SEP, TN-SEP and BAEP were more prolonged than those of normalcontrols, but absolute latencies of VEP were not prolonged
significantly.
Multimodal EP responses except VEP showed improvement toward normal ofr 2 weeks, a steady state until 4 weeks, and then further improvement until 12 weeks after renal rtransplantation. In general, multimodal EP responses except BAEP showed more
significant improvement in 12 weeks than did those 2 weeks after renal transplantation.
MN-SEP did not recover to normal control levels even by 12 weeks after renal transplantation, whereas some of the TN-SEP components had recovered to normal control levels in 12 weeks after renal transplantation, and most of BAEP had recovered to
normal
control llevels in 2 weeks after renal transplantation, but VEP showed no significant alterations compared with normal controls before and after renal transplantation.
In pre-renal transplantation states, most frequent abnormalities were found in MN-SEP (51.3%) whereas least frequent abnormalities were in VEP (5%). BAEP showed only perpheral nervous system dysfunction, whereas the other EP showed central and
peripheral nervous system dysfunction.
CRF patients were divided into 2 age groups, before and after 30 years old, then compared with multimodal EP alterations of those two groups. MN-SEP and TN-SEP showed more rapid improvement in the younger age group, whereas BAEP and VEP showed no
significant alterations in those two groups.
Also CRF patients were divided into 2 groups by uremic durations of multimodal EP, which showed no significant alteration in either of the groups.
Levels of BUN, serum creatinine, hemoglobin. Hematocrit and parathyroid hormone in CRF patients before and after renal transplantation showed significant improvement in 2 weeks after renal transplantation.
These results suggest that multimodal EP tests are useful for early detection of central and peripheral nervous system dysfunction in CRF and these tests might prove useful in the evaluation of the nervous dysfunctions and follow up after renal
transplantation.
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