Skip to main content
Log in

Evoked potentials in children with chronic renal failure, treated conservatively or by continuous ambulatory peritoneal dialysis

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Children with chronic renal failure (CRF) show developmental, intellectual and motor disturbances. It is questionable if an early start of renal replacement therapy may prevent or delay these disturbances. We studied the neurological and intellectual development of children <5 years suffering from CRF (creatinine clearance <20% of normal) prospectively, over a period of 3 years. As part of the neurological study, brainstem auditory evoked potentials (BAEP) and somatosensory evoked potentials (SSEP) were recorded. Measurements were performed in a group of 22 children every 6 months. In 18 of these children CRF was present from birth. Sufficient data were available for analysis in 19 (BAEP) and 22 (SSEP), respectively. A delay of peak I of BAEP gave indications for peripheral conduction disturbances, possibly due to cochlear dysfunction. Brainstem conduction was normal. There were no differences between the children treated conservatively (n = 9) and those treated with continuous ambulatory peritoneal dialysis (CAPD) (n = 10). In children <2.5 years SSEP showed a delayed thalamocortical conduction, which was not observed in older children. This might indicate a delayed myelination in young children with CRF. No differences were found between the children treated conservatively (n = 10) and those treated with CAPD (n = 12).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Biasioli S, D'Andrea G, Feriani M, Chiaramonte S, Fabris A, Ronco C, La Greca G (1986) Uremic encephalopathy: an updating. Clin Nephrol 25: 57–63

    Google Scholar 

  2. Fraser CL, Arieff AI (1988) Nervous system complications in uremia. Ann Intern Med 109: 143–153

    Google Scholar 

  3. Crittenden MR, Holliday MA, Piel CF, Potter DE (1985) Intellectual development of children with renal insufficiency and end stage disease. Int J Pediatr Nephrol 6: 275–280

    Google Scholar 

  4. Geary DF, Fennell RS, Andriola M, Gudat J, Rodgers BM, Richard GA (1980) Encephalopathy in children with chronic renal failure. J Pediatr 96: 41–44

    Google Scholar 

  5. Fennell RS, Fennell EB, Carter RL, Mings EL, Klausner AB, Hurst JR (1990) A longitudinal study of the cognitive function of children with renal failure. Pediatr Nephrol 4: 11–15

    Google Scholar 

  6. Fennell RS, Fennell EB, Carter RL, Mings EL, Klausner AB, Hurst JR (1990) Association between renal function and cognition in childhood chronic renal failure. Pediatr Nephrol 4: 16–20

    Google Scholar 

  7. Rotundo A, Nevins TE, Lipton M, Lockman LA, Mauer SM, Michael AF (1982) Progressive encephalopathy in children with chronic renal insufficiency in infancy. Kidney Int 21: 486–491

    Google Scholar 

  8. Polinsky MS, Kaiser BA, Stover JB, Frankenfield M, Baluarte HJ (1987) Neurologic development of children with severe chronic renal failure from infancy. Pediatr Nephrol 1: 157–165

    Google Scholar 

  9. Bale JF, Siegler RL, Bray PF (1980) Encephalopathy in young children with moderate chronic renal failure. Am J Dis Child 134: 581–583

    Google Scholar 

  10. McGraw ME, Haka-Ikse K (1985) Neurologic-developmental sequelae of chronic renal failure in infancy. J Pediatr 106: 579–583

    Google Scholar 

  11. Geary DF, Haka-Ikse K (1989) Neurodevelopmental progress of young children with chronic renal disease. Pediatrics 84: 68–72

    Google Scholar 

  12. Gerrits GRIM, Monnens LAH, De Abreu RA, Schröder CH, Trijbels JMF, Gabreels FJM (1991) Disturbance of cerebral purine and pyrimidine metabolism in young children with chronic renal failure. Nephron 58: 310–314

    Google Scholar 

  13. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58: 259–263

    Google Scholar 

  14. Jasper HH (1958) The ten-twenty electrode system of the International Federation. EEG Clin Neurophys 10: 731–735

    Google Scholar 

  15. Thivierge J, Côté R (1990) Brainstem auditory evoked response: normative values in children. EEG Clin Neurophys 77: 309–313

    Google Scholar 

  16. Fagan ER, Taylor MJ, Logan WJ (1987) Somatosensory evoked potentials. I. A review of neural generators and special considerations in pediatrics. Pediatr Neurol 3: 249–255

    Google Scholar 

  17. Laureau E, Majnemer A, Rosenblatt B, Riley P (1988) A longitudinal study of short latency somatosensory evoked responses in healthy newborns and infants. EEG Clin Neurophys 71: 100–108

    Google Scholar 

  18. Taylor MJ, Fagan ER (1988) SSEPs to median nerve stimulation: normative data for pediatrics. EEG Clin Neurophys 71: 323–330

    Google Scholar 

  19. Van Diemen NGJ, Eerden HAM van der, Donker AIM, Oe PL, Visser SL, Heimans JJ (1988) Quantitative sensory examination in ESRD patients. Dial Transplant 17: 83–86

    Google Scholar 

  20. Weseley SA, Liebowitz B, Katims JJ (1989) Neuropathy of uremia: evaluation by nerve conduction velocity versus neurospecific current perception threshold. Nephron 52: 317–322

    Google Scholar 

  21. Bazzi C, Pagani C, Sorgato G, Albonico G, Fellin G, D'Amico G (1991) Uremic polyneuropathy: a clinical and electrophysiological study in 135 short- and long-term hemodialyzed patients. Clin Nephrol 35: 176–181

    Google Scholar 

  22. Yu YL, Cheng IK, Cheng CM, Bruce IC, Mok KY, Zhong WY, Chan YW (1991) A multimodal neurophysiological assessment in terminal renal failure. Acta Neurol Scand 83: 89–95

    Google Scholar 

  23. Marsh JT, Brown WS, Wolcott D, Carr CR, Harper R, Schweitzer SV, Nissenson AR (1991) rHuEPO treatment improves brain and cognitive function of anemic dialysis patients. Kidney Int 30: 957–963

    Google Scholar 

  24. Di Paolo B, Di Marco T, Cappelli P, Spisni C, Del Rosso G, Palmieri PF, Evangelista M, Albertazzi A (1988) Electrophysiological aspects of nervous conduction in uremia. Clin Nephrol 29: 253–260

    Google Scholar 

  25. Gafter U, Shvili Y, Levi J, Talmi Y, Zohar Y (1989) Brainstem auditory evoked responses in chronic renal failure and the effect of hemodialysis. Nephron 53: 2–5

    Google Scholar 

  26. De Beaufort CE, André JL, Heimans JJ, Eerden HAM van der, Diemen NGJ van, Duc ML, Pierson M (1989) Peripheral nerve function in children with end-stage renal failure. Pediatr Nephrol 3: 175–178

    Google Scholar 

  27. Suppiej A, Casara G, Boniver C, Pozzan GB, Momini G, Zacchello G, Zacchello F (1991) Somatosensory pathway dysfunction in uremic children. Brain Dev 13: 238–241

    Google Scholar 

  28. Starr A, Amlie RN, Martin WH, Sanders S (1977) Development of auditory function in newborn infants revealed by auditory brainstem potentials. Pediatrics 60: 831–839

    Google Scholar 

  29. Bergstrom L, Jenkins P, Sando I, English GM (1973) Hearing loss in renal disease: clinical and pathological studies. Ann Otol 82: 555–575

    Google Scholar 

  30. Harada T, Yoshitaka N, Iwamori M, Nomura Y (1986) Ototoxicity of neomycin and its penetration through the round window membrane into the perilymph. Ann Otol Rhinol Laryngol 95: 404–408

    Google Scholar 

  31. Quick CA (1976) Hearing loss in patients with dialysis and renal transplants. Ann Otol 85: 776–790

    Google Scholar 

  32. Kligerman AB, Solangi KB, Ventry IM, Goodman AI, Weseley SA (1981) Hearing impairment associated with chronic renal failure. Laryngoscope 91: 583–592

    Google Scholar 

  33. Warady BA, Reed L, Murphy G, Kastetter S, Karlsen E, Alon U, Hellerstein S (1993) Aminoglycoside ototoxicity in pediatric patients receiving long-term peritoneal dialysis. Pediatr Nephrol 7: 178–181

    Google Scholar 

  34. Gilles FH (1976) Myelination in the neonatal brain. Hum Pathol 7: 244–248

    Google Scholar 

  35. Brody BA, Kinney HC, Kloman AS, Gilles FH (1987) Sequence of central nervous system myelination in human infancy. I. An autopsy study of myelination. J Neuropathol Exp Neurol 46: 283–301

    Google Scholar 

  36. Pasman JW, Rotteveel JJ, DeGraaf R, Stegeman DF, Visco YM (1992) The effect of preterm birth on brainstem, middle latency and cortical auditory evoked responses (BMC AERs). Early Hum Dev 31: 113–129

    Google Scholar 

  37. Dambska M, Laure-Kamionowska M (1990) Myelination as parameter of normal and retarded brain maturation. Brain Dev 12: 214–220

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hurkx, W., Hulstijn-Dirkmaat, I., Pasman, J. et al. Evoked potentials in children with chronic renal failure, treated conservatively or by continuous ambulatory peritoneal dialysis. Pediatr Nephrol 9, 325–328 (1995). https://doi.org/10.1007/BF02254201

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02254201

Key words

Navigation