Niels Henrik Buus

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

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review



  • Lotte Hardbo Larsen
  • ,
  • Werner J. Z'Graggen, University of Bern
  • ,
  • Hugh Bostock, University College London
  • ,
  • S. Veronica Tan, The National Hospital for Neurology and Neurosurgery, Queen Square, London
  • ,
  • Niels Henrik Buus
  • Hatice Tankisi

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.

Original languageEnglish
JournalClinical Neurophysiology
Pages (from-to)3125-3135
Number of pages11
Publication statusPublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021 International Federation of Clinical Neurophysiology

    Research areas

  • Electromyography, End-stage renal disease, Frequency ramp, Hemodialysis, Hyperkalemia, Muscle velocity recovery cycles, Uremic myopathy

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