Uremic polyneuropathy: Correlation with parathyroid hormone levels, cross-sectional study among hemodialyzed patients
Keywords:
PTH, uremia, polyneuropathy, CKD, chronic kidney diseases, dialysis, ESRD, neurotoxin, phosphorus, calcium.Abstract
Background: One of the common endocrine sequelae of chronic kidney disease (CKD) is secondary hyperparathyroidism, which increases morbidity and mortality among uremic cases. How CKD triggers the parathyroid gland to secrets parathyroid hormone (PTH) is still an open question. Another common sequel of CKD is peripheral neuropathy (PNP), which involves around 60-100% of dialysis-dependent patients. Nevertheless, the precise pathophysiology of PNP among CKD subjects required additional investigation, particularly in our country. Objectives: To evaluate the correlation of uremic polyneuropathy with PTH levels among patients undergoing hemodialysis. Materials and Methods: 215 patients were recruited in this cross-sectional study (99 women and 116 men). All applicants had ESRD and were assessed by expert physicians, average ages of 17-80 years, on regular visits for hemodialysis unit, receiving standard follow-up hemodialysis regimen. All patients had completed neurophysiological assessments. Biochemical tests of serum levels of Calcium, phosphorus, and PTH were completed according to the manufacturer's instructions. SPSS software was utilized to inspect the statistical investigations. A p-value of 5% had considered significant. Results: Mean age of patients was (48.2±13.4) years. The mean duration of dialysis was 4.7±1.4 years. There were significant differences in the mean levels of serum PTH with the incidence and severity of UPNP (P-0.001 and 0.003), respectively. The prevalence of UPNP was 63.7% among the involved candidates. Of total patients, (51.8%) exhibited moderate UPPN, (29.2%) mild, and (19. 0%) severe type (P<0.05). There were significant differences in the means of age (p-0.001), PTH (p- 0.001), Ca++ (p-0.003), and PO4 levels (p-0.001) between patients with UPNP and patients without UPNP. Conclusion: The main outcomes of this study were the significant correlation of hyperparathyroidism with incidence and with worsening severity of UPNP (P-0.001) and (P-0.013), respectively. Neuropathy is a common sequel in patients with uremia undergoing hemodialysis.
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