To study the spectrum of peripheral neuropathy in chronic kidney disease patients

Background: Chronic Kidney Disease (CKD) is a major public health problem in developed and developing countries, leading to decreased quality of life across the globe. Aim: The clinical and electrophysiological features of peripheral neuropathy in patients with chronic renal failure. The correlation of various biochemical and hematological parameters to that of uremic peripheral neuropathy. Materials and Methods: It was a prospective cross sectional study in 50 Patients admitted with advanced stages of chronic kidney disease. Results: 50 CKD male patients were 30 (60%), female patients were 20 (40%). Among 20 females, 13 (65%) patients had ENMG evidence of polyneuropathy. Polyneuropathy was evident in 78%. Twenty one patients (42%) had clinical symptoms suggestive of polyneuropathy. In 8 patients (16%), it was only detected electrophysiologically. Motor conductions of the tibial, peroneal, median and ulnar nerves showed significant abnormalities in distal motor latency, compound motor action potential (CMAP) amplitude CV among the studied group. In patients with neuropathy there is predominant decrease in CMAP amplitudes with relatively decreased conduction velocity, and prolonged distal latency. Significant abnormalities were found in the peak latency, sensory nerve action potential (SNAP) amplitude and conduction velocity (CV) of the sural, median, ulnar nerves. In patients with neuropathy SNAP amplitudes were decreased significantly with relatively decreased conduction velocity. F wave parameters of peroneal, tibial nerves were abnormal in 30 (60%), and of median 17 (34%), ulnar 16 (32%). We have observed that lower limb involvement is more common compared to upper limb. Sural nerve involvement is seen in all patients with electrophysiological evidence of neuropathy. Conclusion: It can be concluded that axonopathic nature of polyneuropathy with predominant decrease in CMAP and SNAP was confirmed.