Abstract

Neuropathy is the most common neurological consequence of uremia and has the scarce symptoms and definition. Therefore the sensitivity/specificity of clinical scores the neuropathy symptom score (NSS) and the neuropathy disability score (NDS) were evaluated for uremic neuropathy in the present study. 38 hemodialysis patients (23 males, 15 females) and 15 age-sex matched healthy subjects were enrolled. Neurological interrogation and examination of the subjects has been performed before neurophysiological examinations. After the usual 2 days interval in dialysis, electrophysiological studies (EPS) have been performed. Before the EPS, blood samples has been taken before a midweek dialysis; hemoglobin, Hct, and albumin concentrations were measured. The Kt/V value was taken as the average of previous 12 sessions Kt/V values. The mean NSS was 1.66 ± 2.2, mean NDS was 5.02 ± 6.9 in the patient group. According to EPS, 25 patients (65.8%) were diagnosed as having neuropathy [Np (+)] and 13 (34.2%) were normal [Np (-)]. The mean values of median, sural nerve sensory, common peroneal and posterior tibial nerve motor conduction velocities were lower in the patient group compared to controls. Np (+) patients was older than that of Np (-) subjects (50.1 ± 13.8 versus 36 ± 13.6; p = 0.006). Age was the only significant predictor of neuropathy (OR = 1.08, 95% CI, 1.017 to 1.150; p = 0.013). Logistic regression analysis revealed that both NSS (OR = 2.651, 95% CI, 1.1 to 6.4; p = 0.03) and NDS (OR = 1.26, 95% CI, 1.001 to 1.6; p = 0.049) were significantly associated with increased risk of neuropathy. The current study showed that both NSS and NDS are sensitive and specific in the diagnosis of uremic neuropathy and could be used at least as a first step before turn towards the elecrophysiologic studies.

Key words: Uremic neuropathy, neuropathy symptom score, neuropathy disability score, electrophysiological studies, risk prediction