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

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.