Electrophysiological study of peripheral neuropathies in chronic kidney disease patients and relation of severity of peripheral neuropathy with degree of renal failure

Authors

  • Razeen Fatima Department of Medicine, JNMCH, AMU, Aligarh, Uttar Pradesh, India
  • Prakhar Kumar Department of Medicine, JNMCH, AMU, Aligarh, Uttar Pradesh, India
  • Mujahid Beg Department of Medicine, JNMCH, AMU, Aligarh, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20213713

Keywords:

Chronic kidney disease, Nerve conduction study, Neuropathy

Abstract

Background: Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. Peripheral neuropathy occurs in 60-100% patients of CKD. Nerve conduction study is the gold standard method to diagnose uremic neuropathy. In this study we have examined the correlation of nerve conduction latency, amplitude and nerve conduction velocity with serum creatinine, blood urea, serum uric acid levels and compared these parameters among dialysis and non-dialysis dependent CKD patients.

Methods: The present cross-sectional study was conducted on 100 adult patients diagnosed to have and treated for CKD. All cases were subjected to nerve conduction study (NCS) which was performed on median nerve, ulnar nerve, common peroneal nerve, tibial nerve and sural nerve.

Results: The prevalence of neuropathy was 68% in both dialysis and non-dialysis dependent groups. The most involved nerve was sural nerve. On NCS, there was prolongation of nerve latency, decrease in nerve amplitude and nerve conduction velocity with rising blood urea and serum creatinine levels. All these abnormalities were more evident in dialysis dependent patients as compared to non-dialysis dependent patients. Depressed amplitude was the most common abnormality in all the tested nerves.

Conclusions: The nerve latency, amplitude and nerve conduction velocity worsened with rise in blood urea, serum creatinine and decrease in eGFR suggesting that neuropathy progress with increased severity of renal failure. Nerve conduction abnormalities were more prominent in dialysis dependent patients and therefore was associated with more advanced stage of CKD.

 

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References

Atkins RC. The epidemiology of chronic kidney disease. Kidney Int Suppl. 2005;(94):S14-8.

Brouns R, De Deyn PP. Neurological complications in renal failure: a review. Clinical Neurology and Neurosurgery. 2004;107:1-16.

Krishnan AV, Kiernan MC. Neurological complications of chronic kidney disease. Nat Rev Neurol. 2009;5(10):542-51.

Camargo CRS, Schoueri JHM, Alves BCA, da Veiga GRL, Fernando L A, Fonseca FLA et al. Uremic neuropathy: an overview of the current literature. RevistaAssociacao Medica Brasileira. 2019;65(3):469-74.

Vanholder R. Low molecular weight uremic toxins. In: Ronco C, Bellomo R, ed. Critical Care Nephrology, Hingham, MA. Kluwer Academic Publishers. 1998;855-68.

Vanholder R. Pathogenesis of uremic toxicity. In: Ronco C, Bellomo R, ed. Critical Care Nephrology, Hingham, MA. Kluwer Academic Publishers. 1998;845-54.

Arnold R, Issar T, Krishnan AV, Pussel BA. Neurological complications in chronic kidney disease. JRSM Cardiovascular Disease. 2016;5:1-13.

Bolton CF, Baltzan MA, Baltzan RB. Effects of renal transplantation on uremic neuropathy. A clinical and electrophysiologic study. New England Journal of Medicine. 1971;284:1170-5.

Brouns R, De Deyn PP. Neurological complications in renal failure: a review. Clinical Neurology and Neurosurgery. 2004;107:1-16.

Tavee JO, Levin KH. Electrodiagnostic Examination. Chapter 13. In Musculoskeletal Key. 201.

Said G, Krarup. Uremic neuropathy. In Peripheral Nerve Disorders. In: Handbook of Clinical Neurology. 2013;115:607-12.

Mambelli E, Barrella M, Facchini MG, Mancini E, Sicuso C, Bainotti S, et al. The prevalence of peripheral neuropathy in hemodialysis patients. Clin Nephrol. 2012;77(6):468-75.

Jasti DB, Mallipeddi S, Apparao A, Vengamma B, Sivakumar V, Kolli S. A clinical and electrophysiological study of peripheral neuropathies in predialysis chronic kidney disease patients and relation of severity of peripheral neuropathy with degree of renal failure. J Neurosci Rural Pract. 2017;8:516-24.

Aggarwal HK, Sood S, Jain D, Kaverappa V, Yadav S. Evaluation of spectrum of peripheral neuropathy in predialysis patients with chronic kidney disease. Ren Fail. 2013;35(10):1323-9.

Krishnan AV, Kiernan MC. Uremic neuropathy: clinical features and new pathophysiological insights. Muscle & Nerve. 2007;35:273-90.

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Published

2021-09-22

How to Cite

Fatima, R., Kumar, P., & Beg, M. (2021). Electrophysiological study of peripheral neuropathies in chronic kidney disease patients and relation of severity of peripheral neuropathy with degree of renal failure. International Journal of Advances in Medicine, 8(10), 1576–1581. https://doi.org/10.18203/2349-3933.ijam20213713

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Original Research Articles