Polyneuropathy in hemodialysis patients: the most sensitive electrophysiological parameters and dialysis adequacy.
BACKGROUND
Polyneuropathy (PNP) is a common complication in hemodialysis (HD) patients. Electrophysiological parameters are quantitative indices of its severity. The aim of our study was to find the prevalence of pathologic electrophysiological parameters, to assess their prevalence in relation to duration of HD treatment and age, to establish which parameters are the most sensitive in demonstrating PNP and to find an association between them and HD adequacy.


METHODS
We included 84 (50 men, 34 women) HD patients (average age 47.32 years; average dialysis duration 62.56 months) and divided them into three groups according to the duration of HD treatment. Each group was further divided into two subgroups according to age. We included electrophysiological parameters for evaluation of motor and sensory nerve functions (Medelec Sapphire Premiere device). HD adequacy was measured with urea kinetic modeling (Kt/V).


RESULTS
PNP was found in 77 (91.6%) HD patients and was more common in men (P < 0.016). The association between the number of pathologic electrophysiological parameters and age (P < 0.0001), duration of HD treatment (P < 0.009) and HD adequacy (P < 0.0001) was statistically significant. The most sensitive electrophysiological parameter was the latency of the F wave (pathologic values of F wave latency in the lower limbs in 86% patients and in the upper limbs in 49%). Sensory conduction velocities and the amplitudes of the orthodromic sensory action potentials and the M wave were also sensitive parameters. The F wave latency of different nerves was associated with dialysis adequacy.


CONCLUSIONS
PNP is frequent in HD patients and is associated with age and duration of dialysis treatment. The most sensitive electrophysiological parameter of PNP is F wave latency, which may also be used as a parameter of dialysis adequacy.
Hojs-Fabjan
Tanja
T
Department of Neurology, Maribor Teaching Hospital, Ljubljanska ulica 5, 2000 Maribor, Slovenia. tanja.hojs@sb-mb.si
Hojs
Radovan
R
D015984:Causality; D015897:Comorbidity; D004568:Electrodiagnosis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D011115:Polyneuropathies / Q000175:diagnosis* / Q000453:epidemiology*; D011379:Prognosis; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017524:Slovenia / Q000453:epidemiology