الفهرس 
Review of the literatureOnly 14 pages are availabe for public view
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Abstract
This study was aimed to find the prevalence- and pattern of polyneuropathy in CRF patients.
The study included 40 CRF patients divided into 2 groups; the hemodialysis group included 20 patients and the conservative group included 20 patients. Hie study also included 20 healthy volunteers as a control group.
We studied the clinical and electrophysiological aspects of uremic polyneuropathy and reported its prevalent symptoms and signs. Electrophysiologic study included motor conduction studies for the facial, femoral, median, ulnar, tibial and peroneal nerves, F wave study was done for the median, ulnar, tibial and peroneal nerves The study also included sensory conduction study for the sural, ulnar and radial nerves and II reflex study.
We used the total clinical neuropathy score (TNSc) and the total neuropathy score (TNSr) to grade the severity of polyneuropathy on a clinical basis and both clinical and electrophysiological basis respectively.
The study revealed that the prevalence of polyneuropathy In the hemodialysis and conservative groups was 65% and 60 % respectively, with no significant difference in the prevalence of polyneuropathy between them. The prevalence of polyneuropathy in all CRF patients was 62.5%. The polyneuropathy was evident clinically in 37.5% of CRF patients (60%) of all polyneuropathy eases), but 25% of CRF patients (40% of all polyneuropathy cases) had sub-clinical neuropathy that was diagnosed only on an electrophysiological basis.
he conclusions of this study included the followings:
• The prevalence of polyneuropathy in the hemodialysis and conservative groups was 65% and 60 % respectively, with no significant difference between them,
• The prevalence of polyneuropathy in all CRF patients is 62.5%.
• The prevalence of clinically evident polyneuropathy is 37.5% of CRF patients and the prevalence of sub-clinical, neuropathy is 25% of CRF patients..
• The pattern of uremic neuropathy is axonal. affecting sensory fibers more than motor ones, affecting the distal portion of the peripheral nerves more,than the proximal one, affecting both large and small fiber populations with large liber predominance, and affecting the lower limbs more than the upper limbs.
• The most prevalent clinical manifestations of uremic neuropathy are distal paresthesia, reduced or absent ankle reflexes and impaired vibration sense in the big toe.
• RLS, pruritus and burning foot syndrome that occur in patients with CRF are not related to uremic neuropathy.
• flu: most sensitive parameters in detecting uremic neuropathy are abnormalities in 11 reflex, sural nerve parameters, CMA’P and CV of the peroneal and tibial nerves and F wave minimal latency of the peroneal and tibial nerves.The study revealed that there is no significant difference between the clinical and electrophysiological severity of polyneuropathy in hemodialysis treated patients and conservatively treated patients.
The study revealed that there was a significant difference between the mean electrophysiological parameters among the study groups. The difference was found to lies between the hemodialysis group or the conservative group at one side and the control group at the other side except for median latency and CV which was abnormal only in the hemodialysis group.
The study revealed the pattern of uremic polyneuropathy which was found to be axonopathic, affecting sensory fibers more than motor ones, affecting the distal portion of the peripheral nerves more than the proximal one, affecting both large and small fiber populations with large fiber predominance, and affecting lower limbs more than upper limbs.
Uremic neuropathy was found to be more prevalent and more sever in male patients. Also the prevalence and severity of uremic neuropathy were found to be relaled to the duration of kidney failure, but not to the age of the patients.
The study revealed a significant positive correlation between the blood urea, serum creatinine or serum Kf and the severity of uremic neuropathy, and a significant negative correlation between the creatinine clearance and the severity of uremic neuropathy.