Assessment of electrophysiological findings by nerve conduction study in the chronic kidney disease patients

 

Chaudhari Abdul Hameed Abdul Shikur¹, Ashish Baban Kundalwal^2*

 

Abstract              Background: Peripheral polyneuropathy is most common CKD related complication with prevalence of more than 60%. Neuropathy in CKD is distal, symmetrical, mixed sensory motor polyneuropathy affecting lower limbs greater than upper limbs. The prevalence of peripheral neuropathy is directly proportional to duration and severity of CKD. Amis and objective: To assess electrophysiological findings by nerve conduction study in the chronic kidney disease patients Materials and Method: In the present study all the patients visiting to tertiary health care centre of CKD patients (according to KDIGO guidelines) and willing to give informed consent were included as Cases. During the study period total 90 cases of which 60 patients who were receiving conservative management without HD included in pre HD group and 30 patients who were on HD included in HD group. Results: Out of 60 pre HD patients, 33 (55%) showed peripheral neuropathy. Out of 30 HD patients, 24 (80%) showed peripheral neuropathy. Out of total 90 patients, 57 (63.33%) showed peripheral neuropathy. The difference in pre HD and HD was statistically significant (p<0.05). Majority of the patients suffering from neuropathy were belonging to the age group of 45-54years (35.09%) followed by 35-44years (19.30%). Majority of the patients were male (68.42%). Majority of the patients (40.35%) diagnosed with neuropathy were suffering from CKD for more than 5 years. Pure sensory type of PN found in 6 (18.18%) patients in pre HD group, 4 (16.67%) patients in HD group. Total 10 (17.54%) patients showed pure sensory type of PN. Pure motor type of PN was not present in any patient. Sensory-motor type of PN found in 27 (81.82%) patients in pre HD group, 20 (83.33%) patients in HD group. Total 47 (82.46%) patients showed sensory- motor type of PN. Conclusion: Thus we conclude that Peripheral neuropathy is very common in CKD, more common in dialysis patients as compared to predialysis patients. It’s frequency and severity increases as the duration of disease and stage of CKD increases and Sensory motor type of neuropathy is more common than pure sensory type of neuropathy. Distal symmetrical sensory motor neuropathy is common type of neuropathy, which is more in lower limbs than upper limbs. Pure axonal sensory motor and mixed (axonal + demyelinating) sensory motor neuropathy are common patterns of PN in CKD.

Key Words: chronic kidney disease.