Department of Medicine, Pt. B.D. Sharma University of Health Sciences, Rohtak , Haryana , India and.
Ren Fail. 2013;35(10):1323-9. doi: 10.3109/0886022X.2013.828261. Epub 2013 Aug 21.
Neurological complications secondary to the uremic state, contribute largely to the morbidity and mortality in patients with renal failure. The prevalence of peripheral neuropathy remains high in advanced renal dysfunction.
The present cross-sectional study was conducted on 100 adult patients of chronic kidney disease between 18 and 75 years of age with serum creatinine greater than 2 mg/dL. Apart from routine examination and baseline investigations, detailed history was elicited pertaining to patients' neurological symptoms, and scored according to the Neurological Symptom Score. Motor nerve conduction velocity was measured from right median, ulnar, peroneal, and tibial nerves.
It was observed that neurological symptoms increased steadily with raise in serum creatinine. The mean nerve conduction velocities (NCVs) of right median nerve, ulnar nerve, peroneal nerve, and tibial nerve were 51.34 ± 6.07, 53.04 ± 5.91, 44.72 ± 6.14, and 44.20 ± 5.17, respectively. The NCVs of all the tested nerves decreased significantly with increase in serum creatinine levels (p < 0.01): 70% of the patients had uremic polyneuropathy; 6% had asymptomatic neuropathy, 51% had symptomatic non-disabling neuropathy, while disabling neuropathy was seen in 13% of the patients.
Our data suggests that NCV testing when complimented with meticulous neurological assessment can provide invaluable input. These tests apart from helping us detect neuropathy in advanced renal dysfunction; can also detect the disease in largely asymptomatic patients which avoids the necessity to order for detailed neurophysiological investigation.
尿毒症状态引起的神经系统并发症是导致肾衰竭患者发病率和死亡率高的主要原因。在肾功能严重受损的患者中，周围神经病的患病率仍然很高。
本横断面研究纳入了 100 名年龄在 18 至 75 岁之间、血清肌酐大于 2mg/dL 的慢性肾脏病成年患者。除了常规检查和基线调查外，还详细询问了患者的神经系统症状，并根据神经系统症状评分进行了评分。从右侧正中神经、尺神经、腓总神经和胫神经测量运动神经传导速度。
研究发现，随着血清肌酐的升高，神经系统症状逐渐加重。右侧正中神经、尺神经、腓总神经和胫神经的平均神经传导速度（NCV）分别为 51.34±6.07、53.04±5.91、44.72±6.14 和 44.20±5.17。随着血清肌酐水平的升高，所有测试神经的 NCV 均显著降低（p<0.01）：70%的患者患有尿毒症性多发性神经病；6%的患者患有无症状性神经病，51%的患者患有有症状但无残疾的神经病，而 13%的患者患有致残性神经病。
我们的数据表明，NCV 测试与细致的神经评估相结合，可以提供宝贵的信息。这些测试不仅有助于我们在肾功能严重受损时发现神经病，还可以在很大程度上无症状的患者中发现疾病，从而避免需要进行详细的神经生理学检查。
