Chronic kidney disease and peripheral nerve function in the Health, Aging and Body Composition Study

Moorthi, Ranjani N.; Doshi, Simit; Fried, Linda F.; Moe, Sharon M.; Sarnak, Mark J.; Satterfield, Suzanne; Schwartz, Ann V.; Shlipak, Michael G.; Lange‐Maia, Brittney S.; Harris, Tamara B.; Newman, Anne B.; Strotmeyer, Elsa S.

doi:10.1093/ndt/gfy102

Cited by 19 publications

(30 citation statements)

References 50 publications

(58 reference statements)

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“…Further evidence of the impact of CKD on the pathogenesis of peripheral neuropathy was recently highlighted in a population‐based cohort of 908 people that identified evidence of kidney disease as an independent risk factor for abnormal lower limb nerve conduction results . Similarly, the Health, Aging and Body Composition Study highlighted that age‐related peripheral nerve impairments were more common in elderly patients with CKD than in those without, even after adjustment for diabetes . These studies in contemporary cohorts highlight that there is objective evidence of peripheral neuropathy at milder stages of CKD than historically recognised and that, even in patients with diabetes, the coexistence of CKD is an important contributor to neuropathy.…”

Section: Implications Of Peripheral Neuropathy In Ckdmentioning

confidence: 95%

“…12 Similarly, the Health, Aging and Body Composition Study highlighted that age-related peripheral nerve impairments were more common in elderly patients with CKD than in those without, even after adjustment for diabetes. 13 These studies in contemporary cohorts highlight that there is objective evidence of peripheral neuropathy at milder stages of CKD than historically recognised and that, even in patients with diabetes, the coexistence of CKD is an important contributor to neuropathy. This recognition may provide a window of opportunity for early identification and management ( Table 2).…”

Section: Implications Of Peripheral Neuropathy In Ckdmentioning

confidence: 98%

“…An inverse relationship between peripheral neuropathy and objective markers of lower limb function, such as walking speed, have been shown in the general population and in ESKD . Although not systematically examined, it seems likely that neuropathy may also lead to significant functional impairment in moderate CKD …”

Section: Implications Of Peripheral Neuropathy In Ckdmentioning

confidence: 99%

“…Peripheral neuropathy affects 60–90% of dialysis patients and has long been recognised in patients with advanced CKD . More recently, both population‐ and CKD‐specific studies have demonstrated evidence of peripheral neuropathy in earlier stages of CKD . Given the prevalence and impact of peripheral neuropathy in CKD, there is a pressing need for targeted treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

“…5,9 More recently, both population-and CKD-specific studies have demonstrated evidence of peripheral neuropathy in earlier stages of CKD. [10][11][12][13] Given the prevalence and impact of peripheral neuropathy in CKD, there is a pressing need for targeted treatment strategies. Recent research is emerging that suggests optimising potassium control, including in patients before the development of ESKD, may represent one such strategy to improve neuromuscular outcomes in CKD.…”

Section: Introductionmentioning

confidence: 99%

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Potassium control in chronic kidney disease: implications for neuromuscular function

Arnold

Pianta

Pussell

et al. 2019

Internal Medicine Journal

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In Australia approximately 1.7million adults have evidence of chronic kidney disease (CKD). This complex disease can result in a multitude of complications, including hyperkalaemia which common and well recognised. . The advent of new therapeutics aimed at lowering serum potassium have raised the possibility of optimising potassium control to enable greater use of renin-angiotensin-aldosterone system inhibitors in the management of CKD. Recent studies suggest that hyperkalaemia also has implications for peripheral neuropathy in CKD, a complication that substantially contributes to patient morbidity. This review examines evidence of the relationship between potassium and peripheral neuropathy with discussion of clinical implications. We searched PubMed for original and review articles using prespecified key words, clinical guidelines and population data. The major findings were that contemporary CKD cohorts demonstrate a high prevalence of peripheral neuropathy, even in stage 3-4 CKD, including those without diabetes. The severity of the problem has been emphasized by an ominous rise in foot complications and amputation rates in dialysis patients, highlighting the need for increased awareness of the condition in earlier stages of CKD and targeted treatment strategies. It is likely that the pathophysiology of peripheral neuropathy in CKD is multifaceted with potential influences from potassium, vascular abnormalities, diabetes, inflammation and unknown middle molecules. Despite these complexities, the relationship between potassium and nerve function in dialysis has been well established and recent research in stage 3-4 CKD suggests that assertive potassium control may improve neuromuscular outcomes in CKD. These small studies should be confirmed in large, multicenter settings. This article is protected by copyright. All rights reserved.

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Section: Implications Of Peripheral Neuropathy In Ckdmentioning

confidence: 95%

Section: Implications Of Peripheral Neuropathy In Ckdmentioning

confidence: 98%