Central and peripheral nervous system effects of chronic renal failure.

作者: Cynthia A. Mahoney , Allen I. Arieff , William J. Leach , Virginia C. Lazarowitz , A.I Arieff

DOI: 10.1038/KI.1983.141

关键词: Peripheral nerveCalcium contentInternal medicineIn patientGynecologyCalciumChronic renal failureOsmoleEndocrinologyPeripheral nervous systemUreteral ligationMedicine

摘要: Central and peripheral nervous system effects of chronic renal failure. Although neurologic dysfunction is a major cause disability in patients with failure, there little knowledge the underlying metabolic defect(s). We used canine model to study failure (CRF: 4 months after 1-⅞ nephrectomy, GFR 11 ± 2 ml/min) on composition function system. also studied effect acute (ARF: 3.5 days bilateral ureteral ligation) nerve function. In dogs CRF for intracellular pH brain cerebro-spinal fluid (CSF) remained normal, despite acidemia. Osmotic equilibrium plasma CSF (and thus normal water content) was maintained by almost equivalent increases urea idiogenic osmoles (25 mmoles/kg H O 23 26 mOsm/kg O, respectively). Electrolyte concentration tissue did not change significantly. Calcium content increased cortical gray matter hypothalamus CRF, but six other regions measured. Functional changes measured electroencephalogram were just as severe those previously seen ARF. The motor conduction velocity (MNCV) ARF up 6 CRF. Similarly, calcium decreased low Thus, duration produced marked alterations central composition. Increases and/or appearance may be involved pathogenesis dysfunction. contrast findings brain, sodium fell acutely, Despite these compositional changes, function, MNCV, unaffected. Effets de l'insuffisance renale chronique sur le systeme nerveux et peripherique. Bien que dysfonctionnement neurologique soit une majeure d'invalidite chez des malades atteints d'insuffisance chronique, il n'y peu donnees le(les) trouble(s) metabolique(s) sous-jacent(s). Nous avons utilise un modele canin pour etudier les mois apres nephrectomie, la fonctionnement du nerveux. egalement etudie l'effet l'insuffissance aigue jours ligature ureterale bilaterale fonction nerf Chez chiens depuis mois, intracellulaire cerveau fluide cerebro-spinale resterent normales, malgre l'acidemia metabolique. L'equilibre osmotique avec (et donc contenu d'eau) etait maintenu par augmentations pres equivalentes l'uree idiogeniques dans respectivement). La d'electrolytes l'eau tissulaire cerebrale n'a pas significativement. Le calcique augmente matiere grise corticale l'hypothalamus mais autres mesurees. Les modifications fonctionnelles mesurees l'electroencephalogrammes etaient aussi severes celles vues auparavant en velocite compartement motique ne changeait jusqu'a De facon identique, nerfs diminue restait bas CFR. Ainsi, entraine marquees central. Des et/ou l'apparition d'osmoles pourraient etre impliquees pathogenie Par opposition resultats cerveau, chute marquee, est reste renale. Malgre ces composition, nerveux, mesure MNCV n'etait affecte.

参考文章(40)
A. Tizianello, G. De Ferrari, G. Gurreri, N. Acquarone, Effects of metabolic alkalosis, metabolic acidosis and uraemia on whole-body intracellular pH in man. Clinical Science. ,vol. 52, pp. 125- 135 ,(1977) , 10.1042/CS0520125
Johnson Wj, Dyck Pj, O'Brien Pc, Lambert Eh, Segmental demyelination secondary to axonal degeneration in uremic neuropathy. Mayo Clinic proceedings. ,vol. 46, pp. 400- 431 ,(1971)
Neil H. Raskin, Robert A. Fishman, Neurologic disorders in renal failure (first of two parts). The New England Journal of Medicine. ,vol. 294, pp. 143- ,(1976) , 10.1056/NEJM197601152940306
S Massry, A I Arieff, R Guisado, Muscle water and electrolytes in uremia and the effects of hemodialysis. Journal of Laboratory and Clinical Medicine. ,vol. 89, pp. 322- 331 ,(1977)
P. K. THOMAS, K. HOLLINRAKE, R. G. LASCELLES, D. J. O'SULLIVAN, R. A. BAILLOD, J. F. MOORHEAD, J. C. MACKENZIE, The polyneuropathy of chronic renal failure. Brain. ,vol. 94, pp. 761- 780 ,(1971) , 10.1093/BRAIN/94.4.761
Allen I. Arieff, Shaul G. Massry, Alberto Barrientos, Charles R. Kleeman, Brain water and electrolyte metabolism in uremia: Effects of slow and rapid hemodialysis Kidney International. ,vol. 4, pp. 177- 187 ,(1973) , 10.1038/KI.1973.100
G. Maschio, G. Bazzato, Elda Bertaglia, D. Sardini, G. Mioni, Angela D’Angelo, A. Marzo, Intracellular pH and electrolyte content of skeletal muscle in patients with chronic acidosis. Nephron. ,vol. 7, pp. 481- 487 ,(1970) , 10.1159/000179849
C.R. Blagg, F. Kemble, D. Taverner, Nerve conduction velocity in relationship to the severity of renal disease. Nephron. ,vol. 5, pp. 290- 299 ,(1968) , 10.1159/000179638
JOHN KILEY, Electroencephalographic Evaluation of Uremia Archives of Internal Medicine. ,vol. 116, pp. 67- 73 ,(1965) , 10.1001/ARCHINTE.1965.03870010069009
Arnold S. Relman, Metabolic consequences of acid-base disorders Kidney International. ,vol. 1, pp. 347- 359 ,(1972) , 10.1038/KI.1972.46