ACUTE EFFECT OF HEMODIALYSIS ON SYMPATHETIC SKIN RESPONSE

Abstract

Sympathetic skin response (SSR) is a useful and simple test for unmyelinated axon function in peripheral sensorimotor neuropathies. SSR was tested on a group of patients undergoing chronic regular hemodialysis before and after a single dialysis session. Nineteen patients in hemodialysis for more than three months were included. Nine patients were on dialysis with cellulosic membranes (CA, 3 male and 6 female, aged 57.7 ± 16.4 years) and ten ones were on dialysis with non-cellulosic membranes (NC, 4 male and 6 female, aged 50.2 ± 15.9 years) were studied. There were no differences neither in Kt/V values (NC 1.37 ± 0.34 vs. CA 1.22 ± 0.27) nor in TAC ones (NC 41.5 ± 18.2 vs. CA 41.3 ± 14.1 mg/dL). After hemodialysis with NC amplitude significantly increased (994 ± 1015 vs. 382 ± 465 μv baseline, p < 0.05). Latency did not change (1.76 ± 0.83 vs. 2.07 ± 0.50 s baseline). After hemodialysis with CA neither amplitude changed (1368 ± 1074 vs. 1240 ± 1594 μv baseline), nor did latency (1.79 ± 0.35 vs. 1.94 ± 0.59 s baseline). Hemodialysis with non-cellulosic membranes (but not with cellulose acetate) yields a short-term improvement of sympathetic skin response. This effect is similar to those seen in nerve conduction velocities and it may be related to increased middle-molecules depuration.

• Chronic renal failure
• Hemodialysis
• Polyneuropathy
• Sympathetic skin response