Effects of haemodialysis on intraneural blood flow in end-stage kidney disease

Introduction: We quantified intraneural blood flow (INBF) in 18 patients with end-stage kidney disease (ESKD) and examined its relationship with nerve size, neuropathy severity and nerve excitability parameters. Methods: Sonographic measurements of the median nerve were performed at the same site before and after haemodialysis. INBF was quantified by analysing power Doppler sonograms to obtain the vessel score (VSc) and maximum perfusion intensity(MPI). Corresponding median motor nerve excitability studies were performed. Neuropathy severity was assessed using total neuropathy score (TNS). Results: 39% of ESKD patients had detectable INBF compared to none in the control group (P<0.0001). Patients with detectable INBF had larger nerves and more severe neuropathy (p<0.01). INBF parameters were significantly reduced after a session of dialysis (VSc: p<0.01; MPI: p<0.01). A significant relationship was found between interdialytic change in INBF and changes in nerve excitability. Discussion: Increased INBF is a potential marker for neuropathy severity in ESKD patients. This article is protected by copyright. All rights reserved.