The relationship of electrophysiological parameters of uremic polyneuropathy and uremic toxins in patients with chronic kidney disease.

Abstract

We aimed to study the correlation of measurable uremic toxins with electrophysiological parameters of uremic polyneuropathy in chronic kidney disease (CKD) patients. This study was conducted between January 2018 and December 2018, 40 CKD patients on hemodialysis (HD) and 40 controls were included in the present study. Prevalence of peripheral neuropathy in CKD patients was 50% clinically and 65% of patients found to have neuropathy by electrophysiological study. The mean age of patients was 36.9 ± 12 years in which, 26 (65%) were male and 14 (35%) were female. All patients were recently diagnosed CKD on HD since <1 year duration. In the present study 16 (40%) patients had mild-to-moderate neuropathy and 4 (10%) had severe neuropathy according to modified NDS score. The most common pattern of neuropathy was axonal and mixed sensorimotor. On correlation of serum creatinine (Cr) and blood urea nitrogen (BUN) with nerve conduction study parameters, statistically significant association was present but other uremic toxins including serum potassium, calcium, phosphorus, uric acid, and parathyroid hormone did not correlate with neuropathy indices. Peripheral neuropathy is common in CKD patients causing significant morbidity at very early stage and though BUN and Cr are dialyzable toxins, they correlate significantly with neuropathy severity and can be guiding markers for optimization of dialysis therapy.