The role of potassium in muscle membrane dysfunction in end-stage renal disease.

Autor: Larsen LH; Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark., Z'Graggen WJ; Departments of Neurology and Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Switzerland., Bostock H; Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom., Tan SV; MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom., Buus NH; Department of Renal Medicine, Aarhus University Hospital, Denmark., Tankisi H; Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: hatitank@rm.dk.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2021 Dec; Vol. 132 (12), pp. 3125-3135. Date of Electronic Publication: 2021 Oct 12.
DOI: 10.1016/j.clinph.2021.09.012
Abstrakt: Objective: Uremic myopathy is a condition seen in end-stage renal disease (ESRD), characterized by muscle weakness and muscle fatigue, in which the pathophysiology is uncertain. The aim of this study was to assess the role of abnormal serum constituents in ESRD patients by relating them to the excitability properties of the tibialis anterior muscle, at rest and during electrically induced muscle activation, by recording muscle velocity recovery cycles (MVRC) and frequency ramp responses.
Methods: Eighteen ESRD patients undergoing hemodialysis were evaluated by blood sample, MVRC, and frequency ramp (before and near the end of dialysis treatment), quantitative electromyography, and nerve conduction studies. Patients were compared to 24 control subjects.
Results: In patients, muscle relative refractory period, early supernormality, late supernormality after 5 conditioning stimuli, and latency of the last of 15 and 30 frequency ramp pulses were strongly associated with potassium levels (p < 0.01), showing depolarization before and normalization in the end of hemodialysis.
Conclusions: In ESRD patients, the muscle membrane is depolarized, mainly due to hyperkalemia.
Significance: Since normal muscle fatigue has been attributed to potassium-induced depolarization, it seems likely that this mechanism is also a major cause of the exaggerated muscle fatigue and weakness in ESRD patients.
Competing Interests: Declaration of Competing Interest Professor Hugh Bostock receives royalties from UCL for sales of his Qtrac software used in this study. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 International Federation of Clinical Neurophysiology. All rights reserved.)
Databáze: MEDLINE
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