Uremic neuropathy: an overview of the current literature

Abstract

SUMMARY INTRODUCTION: Peripheral neuropathy is a disorder that affects the cell body, axon or myelin of motor or peripheral sensory neurons and occurs in 60-100% of patients who are submitted to dialysis due to chronic kidney disease. Uremic neuropathy (UN) is attributed to the accumulation of organic waste, evident in patients with reduced glomerular filtration rate. OBJECTIVES: This review aims to make clinical characteristics of uremic neuropathy evident enabling early diagnosis and treatment. METHODS: This is a literature review of articles published on PubMed over the last 10 years using “Uremic Neuropathy” as “Title/Abstract”. RESULTS: A total of nine articles that met the inclusion criteria were included. UN is a distal symmetric sensorimotor polyneuropathy that occurs due to the accumulation of uremic toxins associated with an oxidative stress-related free radical activity. Hyperkalemia is thought to play an important role in its pathophysiology. Diagnosis depends on nerve conduction studies, and treatment includes dialysis or renal transplant. CONCLUSION: Clinical presentations of UN are broad and non-specific; nonetheless, it is important to detect early changes in order to avoid its progression. The earlier UN is diagnosed and treated, the more successful are the clinical outcomes.

Lower Limb Arterial Ischemia: An Independent Risk Factor of Sudomotor Dysfunction in Type 2 Diabetes

“…Furthermore, patients with sudomotor dysfunction had poor renal function in this study, which may be due to the chronic accumulation of organic waste induced by the decline of glomerular filtration rate, triggering oxidative stress and over-generation of free radicals, thereby leading to autonomic nerve damage. 32 …”

“…Furthermore, patients with sudomotor dysfunction had poor renal function in this study, which may be due to the chronic accumulation of organic waste induced by the decline of glomerular filtration rate, triggering oxidative stress and over-generation of free radicals, thereby leading to autonomic nerve damage. 32 The main strength of this study is that arterial ischemia was evaluated by ABI, TBI and TcPO2, which can more comprehensively elucidate the relationship between arterial ischemia and sudomotor dysfunction. Moreover, easily available POCDs were used to evaluate sudomotor function and lower limb arterial ischemia, which facilitated rapid clinical screening.…”

Shear Wave Elastography in the Diagnosis of Peripheral Neuropathy in Patients With Chronic Kidney Disease Stage 5

“…We obtained all relevant data including latencies, amplitudes, and conduction velocity. The case definition for UPN was based on the results of electromyography, which is the gold standard method ( 18 ).…”