Neurological Assessment of Hemodialysis Patients a Single Center Study

Background Neurological impairment in patients with chronic kidney disease remains an important source of morbidity and mortality. Hemodialysis patients have not fully corrected neurological manifestations. This study was designed to conduct the prevalence of neurological manifestations among adult hemodialysis patients seen in the Nephrology center of Medical City- Baghdad Teaching Hospital in the period from November 2011 to November 2012. Patients and Methods This was a prospective cross-sectional hospital based study. One hundred and four adult hemodialysis patients were included in the study using a simple, direct standardized questionnaire including history, systemic, neurological examinations, body weight and investigations like: Blood urea, serum creatinine, PCV%, and electrolytes. Results: Neurological disorders are common among patients on hemodialysis where weakness was the most common symptom and fine tremor was the most common sign. Most of the patients enrolled in the study had partially dependent gait. The duration that the patient is on hemodialysis has a negative impact, and the neurological symptoms like headache, insomnia, fine tremor, proximal myopathy, distal myopathy, muscle cramps, weak/absent reflexes, peripheral neuropathy, postural hypotension, abnormal valsalva, nocturnal/post-prandial diarrhea and dependent gait were more common in patients whose spent more than one year on hemodialysis and the difference was statistically significant. The body mass index can affect some of the neurological manifestations and our study shows that there was a statistically significant difference in proximal weakness, distal weakness, weak/absent reflexes, peripheral neuropathy, postural hypotension, abnormal valsalva, dependent gait and partially dependent gait which are presented more in 2 patients with BMI < 18.5 kg/m . Patients with anemia (Hb<10 gm/dl) had more postural hypotension than those with (Hb>10 gm/d) and the difference statistically was significant while other neurological manifestations not. The hepatitis state of the patient has no impact on the neurological manifestations of the patients.