A clinical and electrophysiological study of peripheral neuropathies in peritoneal dialysis patients: Our experience from rural South India

Abstract

The objective was to study the prevalence, clinical features, electrophysiological features, and severity of peripheral neuropathy in chronic kidney disease (CKD) patients on peritoneal dialysis (PD) and effect of the presence of diabetes mellitus (DM). Between May 2015 and December 2016, 100 CKD patients on PD were assessed. The prevalence of peripheral neuropathy was 65% based on clinical symptoms and 92% based on electrophysiological parameters. The mean age was 55.7 ± 10.9 years. About 64% were male. Twelve patients (12%) had motor weakness, 64 patients (64%) had positive symptoms and 60 patients (60%) had negative symptoms. Autonomic symptoms were seen in 14 patients (14%). Definite damage was seen in 68 patients (68%), early damage was seen in 16 patients (16%). In PD patients with DM (n = 50), 50 patients (100%) had definite damage. In PD patients without DM (n = 50), 18 patients (36%) had definite damage, 16 patients (32%) had early damage. In CKD patients on PD, patients aged >50 years (definite damage in 75.7%) showed more severe peripheral neuropathy when compared to patients aged ≤50 years (definite damage in 53%). Most common nerves involved in the present study were median motor nerve, sural nerve, ulnar sensory nerve, common peroneal nerve, posterior tibial nerve followed by the median sensory nerve. Peripheral neuropathy is common in CKD patients on PD, with higher prevalence and severity in elderly females and diabetics. Rationale management of diabetes in CKD patients on PD probably lowers the prevalence and severity of peripheral neuropathy.