Sonbhadra Ahibhushan, Reddy Bandi V Chaithanya, Saini Arushi G, Tiewsoh Kara, Paria Pradip, Kesavan Shivan, Suthar Renu, Dawman Lesa, Attri Savita
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatrics, Pediatric Neurology Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ann Indian Acad Neurol. 2022 May-Jun;25(3):389-393. doi: 10.4103/aian.aian_1067_21. Epub 2022 Jun 24.
Peripheral neuropathy in chronic kidney disease (CKD) is the most common neurological complication. We aimed to look at the prevalence and patterns of neuropathy in children with CKD.
This cross-sectional study was conducted over 1 year in children with CKD, stage III and above. Nerve conduction studies (NCS) were performed as per standard protocols using surface electrodes on the muscles and by supramaximal stimulation of the corresponding nerves. Presence of electrophysiological abnormalities in the absence of clinical symptoms or signs was considered as subclinical neuropathy.
Nearly 45 children were evaluated. The majority were males ( = 39, 86.7%). The mean age was 7.9 ± 3 years (range 2-14). The mean estimated glomerular filtration rate (GFR) at enrolment was 23.3 ± 14.6 mL/min/1.73 m (range 5-67). The majority of children were in stage III ( = 19, 42%), followed by stages V ( = 15, 33%) and IV ( = 11, 25%). There was no evidence of clinical neuropathy; 13 children (29%) showed subclinical neuropathy. All the nerves had an axonal pattern of involvement. Motor polyneuropathy was most common type of peripheral neuropathy. The commonest nerves involved were tibial and common peroneal nerves. There were no biochemical or clinical predictors of neuropathy in our cohort.
The prevalence of subclinical neuropathy is high in children with CKD, stage III and above. Axonal motor polyneuropathy is the predominant pattern. Electrophysiological assessment of nerve function should be routinely done in children with advanced stages of CKD to prevent chronic complications.
慢性肾脏病（CKD）中的周围神经病变是最常见的神经并发症。我们旨在研究CKD患儿神经病变的患病率及模式。
这项横断面研究在CKD III期及以上的患儿中进行了1年。按照标准方案，使用表面电极对肌肉进行检查，并对相应神经进行超强刺激，进行神经传导研究（NCS）。在没有临床症状或体征的情况下出现电生理异常被视为亚临床神经病变。
共评估了近45名儿童。大多数为男性（n = 39，86.7%）。平均年龄为7.9±3岁（范围2 - 14岁）。入组时平均估计肾小球滤过率（GFR）为23.3±14.6 mL/min/1.73 m²（范围5 - 67）。大多数儿童处于III期（n = 19，42%），其次是V期（n = 15，33%）和IV期（n = 11，25%）。没有临床神经病变的证据；13名儿童（29%）表现出亚临床神经病变。所有神经均呈现轴索性受累模式。运动性多发性神经病变是周围神经病变最常见的类型。最常受累的神经是胫神经和腓总神经。在我们的队列中，没有神经病变的生化或临床预测指标。
CKD III期及以上患儿亚临床神经病变的患病率很高。轴索性运动性多发性神经病变是主要模式。对于CKD晚期患儿，应常规进行神经功能的电生理评估，以预防慢性并发症。
