Prevalence and predictors of peripheral neuropathy in nondiabetic children with chronic kidney disease

Yoganathan, Sangeetha; Bagga, Arvind; Gulati, Sheffali; Toteja, Gurudayal Singh; Hari, Pankaj; Sinha, Aditi; Pandey, Ravindra Mohan; Irshad, Mohammad

doi:10.1002/mus.26027

Cited by 8 publications

(11 citation statements)

References 32 publications

(73 reference statements)

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“…In contrast, Ackil et al showed that sural nerve conduction abnormalities in 59% of children, and motor conduction studies revealed motor conduction abnormality in 29% of children on dialysis (19) . The tibial and common peroneal nerves were most commonly affected as there was reduced conduction velocity and amplitude in our patients, this in agreement with Yoganathan et al (26) . Another study reported that low peroneal nerve conduction velocity was considered as a sensitive measure for the diagnosis of uremic neuropathy (28) .…”

Section: Discussionsupporting

confidence: 93%

“…Peripheral neuropathy prevalence in the current work was 22%; axonal motor and sensory neuropathy (81.8%) is more common than demyelinating motor neuropathy (18.2%). Yoganathan et al demonstrated that the prevalence of peripheral neuropathy was 52%; axonal neuropathy (80.8%) was more common than demyelinating neuropathy (11.5%) and motor neuropathy was the predominant type, followed by sensory motor neuropathy (26) . Few studies in children reported that the prevalence ranging from 0-59% (27) .…”

Section: Discussionmentioning

confidence: 99%

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Neurophysiological and Neuroradiological Changes in children with chronic kidney disease

Naby

Elshafie

Bahbah

et al. 2020

Preprint

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Background: Patients with chronic kidney disease on hemodialysis are frequently afflicted with neurological complications. These complications can potentially affect both the central and peripheral nervous systems. Common neurological complications in CKD include stroke, cognitive dysfunction, and encephalopathy, peripheral and autonomic neuropathies.Aim: to detect the neurological manifestations and complications in children with chronic kidney disease through neurophysiological and neuro-radiological findings.Methods: The study included 50 patients with CKD admitted to pediatric nephrology unit. Their history, complete physical and neurological examination finding had been recorded. All of them underwent nerve conduction, electromyography (EMG), electroencephalography (EEG) and magnetic resonance imaging (MRI).Results: Included children were 23 males and 27 females with mean age of (12.8±3.44 year). 11 (22%) patients of end stage renal disease developed polyneuropathy mostly of axonal polyneuropathy pattern while 78% of them showed normal electrophysiological studies. No myopathy was detected. Abnormal electroencephalography findings were detected in 18% of patients in the form of generalized and focal (temporal, occipital and frontal) epileptogenic activity had been found. Abnormal MRI findings were detected in 16% of patients mostly of encephalomalachia. Conclusion: Neurological status in patients with end stage renal disease on maintenance hemodialysis therapy was impaired. Uremic neuropathy is highly prevalent in these patients. They developed polyneuropathy mostly of axonal polyneuropathy pattern. EEG is a useful tool for detection of subclinical or latent uremic encephalopathy and/or epileptogenic activity. Early detection and management of these neurological conditions may estimate a window to reduce physical disability in children with CKD.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Neurophysiological and Neuroradiological Changes in children with chronic kidney disease

Naby

Elshafie

Bahbah

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…The current study illustrated normal motor and sensory nerve conduction of both the ulnar and median nerves on both sides in our polyneuropathy patients; this is in agreement with Yoganathan et al (28). Analytical interpretation of EMG results of the current study revealed normal motor units in 41 patients (82%), while nine patients (18%) revealed large polyphasic motor units (neuropathic).…”

Section: Discussionsupporting

confidence: 92%

“…Ackil et al (20) showed that 59% of children had sural nerve conduction abnormalities, and motor conduction abnormality was found in 29% of children on maintenance dialysis. The most common affected nerves were the tibial and common peroneal nerves as there was reduced conduction velocity and amplitude in our patients; this is in agreement with Yoganathan et al (28). Another study reported that low peroneal nerve conduction velocity was considered as a useful tool for uremic neuropathy detection (29).…”

Section: Discussionsupporting

confidence: 91%

“…Some studies reported UN prevalence ranging from 0 to 59% (27). Yoganathan et al (28) demonstrated that uremic neuropathy prevalence was 52%, with axonal neuropathy (80.8%) and demyelinating neuropathy (11.5%) with predominant motor neuropathy. Ackil et al (20) showed that 59% of children had sural nerve conduction abnormalities, and motor conduction abnormality was found in 29% of children on maintenance dialysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neurophysiological and Neuroradiological Changes in Children With Chronic Kidney Disease

et al. 2020

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Background: Patients with chronic kidney disease (CKD) on maintenance hemodialysis frequently present with neurological complications. These complications include peripheral neuropathy, encephalopathy, and stroke. Objectives: To detect the prevalence of neurological manifestations and complications in children with CKD through neurophysiological and neuro-radiological findings. Methods: The study included 50 patients with CKD admitted to a pediatric nephrology unit. Their history and complete physical and neurological examination findings had been recorded. All patients underwent nerve conduction, electromyography, electroencephalography, and magnetic resonance imaging of the brain. Results: Fifty children of both sexes (23 males and 27 females) with a mean age of (12.08 ± 3.46 year) were studied. Eleven (22%) patients with CKD developed polyneuropathy, mostly of an axonal polyneuropathy pattern, while 39 (78%) of them showed normal electrophysiological studies. No myopathy was detected. Abnormal electroencephalography findings were detected in 18% of patients, mostly generalized and focal (temporal, occipital, and frontal) epileptogenic activity. Abnormal MRI brain findings were detected in 16% of patients, mostly of encephalomalacia. Conclusion: Uremic neuropathy was highly prevalent in children with CKD on maintenance hemodialysis. They developed polyneuropathy, mostly of an axonal polyneuropathy pattern. EEG is a useful method for early recognition of subclinical uremic encephalopathy and/or epileptogenic activity. Early demonstration and management of uremic neurological conditions may decrease the physical disability of CKD patients.

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Study of Vitamin D and Interleukin 10 Levels in Uremic Peripheral Neuropathy in Hemodialysis Children.

Arab¹,

Ghonimi²,

El-Shahawy³

et al. 2023

GEGET

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Introduction: One of the frequent neurological complications of end stage kidney disease (ESKD) is uremic peripheral neuropathy (UPNP). A rapidly expanding literature on the relationship between 25(OH) vitamin D and UPNP shows a high link between them. Interleukin 10(IL-10) reduced level may contributes to UPNP. The aim was to assess the correlation between serum levels of vitamin D and IL-10 with the incidence of UPNP in children on regular hemodialysis. Methods: A cross-sectional study included 71 children on regular hemodialysis, aged between 3 and 18 years. They were sub classified into two groups after assessment with nerve conduction studies (NCS) and neuropathy score; group I consisted of 24 patients with PNP and group II consisted of 47 patients without PNP. All patients were subjected to clinical examination, laboratory investigations and serum 25(OH) vitamin D and IL-10. Results: Patients with PNP had significantly lower serum levels of IL-10 (P<0.001**) and 25(OH) vitamin D (P=0.003*) than those without PNP. 70% of patients with PNP had vitamin D deficiency with statistically significant difference (P < 0.001). The serum levels of 25(OH) vitamin D and IL-10 have a statistically significant negative correlation with severity of UPNP. There was a significant positive correlation between IL-10 and vitamin D levels (P= 0.022). Longer duration of dialysis with age more than 11 years, low vitamin D, and low IL-10 were independent variables for UPNP. Conclusions: Low vitamin D and IL-10 levels increase the risk of PNP in children on hemodialysis

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Prevalence and predictors of peripheral neuropathy in nondiabetic children with chronic kidney disease

Abstract: Electrodiagnostic studies should be performed in children with CKD to assess for peripheral neuropathy for the purpose of optimizing medical care. Muscle Nerve 57: 792-798, 2018.

Cited by 8 publications

References 32 publications

Neurophysiological and Neuroradiological Changes in children with chronic kidney disease

Neurophysiological and Neuroradiological Changes in children with chronic kidney disease

Neurophysiological and Neuroradiological Changes in Children With Chronic Kidney Disease

Study of Vitamin D and Interleukin 10 Levels in Uremic Peripheral Neuropathy in Hemodialysis Children.

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