Nerve cross-sectional area in advanced uremic neuropathy: A nerve ultrasound pilot study.

Autor: Tosberg JH; Department of Neurology and Neurogeriatrics, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Bochum, Germany., Mork H; Department of Neurology and Neurogeriatrics, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Bochum, Germany., Klimas R; Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany., Radermacher J; Department of Nephrology and Hemodialysis, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Bochum, Germany., Schellinger PD; Department of Neurology and Neurogeriatrics, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Bochum, Germany., Philipps J; Department of Neurology and Neurogeriatrics, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Bochum, Germany.
Jazyk: angličtina
Zdroj: Journal of neuroimaging : official journal of the American Society of Neuroimaging [J Neuroimaging] 2024 Jul-Aug; Vol. 34 (4), pp. 486-492. Date of Electronic Publication: 2024 May 19.
DOI: 10.1111/jon.13205
Abstrakt: Background and Purpose: Uremic neuropathy (UN) is a disabling neuropathy in end-stage kidney disease (ESKD) affecting the majority of patients receiving long-term hemodialysis (HD). One previous nerve ultrasound study reported an increased cross-sectional area (CSA) of the median nerve in moderate UN, while another study found enlarged sural nerves in small-fiber polyneuropathy associated with ESKD. The present cohort study aims to analyze bilateral CSA of multiple nerves in UN.
Methods: Ten nondiabetic ESKD patients with UN on HD for at least 2 years and 10 healthy age-matched controls underwent bilateral ultrasound examinations with CSA measurements in 13 arm and leg nerve sites. Nerve conduction studies (NCS) and the total neuropathy score (TNS) were recorded. Pearson's coefficient and the Mann-Whitney U-test were used to analyze correlations and compare groups.
Results: ESKD patients presented advanced neuropathic symptoms (mean TNS 15.9). NCS showed significantly reduced motor and sensory amplitudes in the UN group compared to the control group, and a slightly reduced nerve CSA was observed in 5 of 13 nerve sites (p < .05); the other nerve sites were not enlarged. Sural nerve CSA (p < .05) and sensory amplitude (p < .01) were negatively correlated with the TNS.
Conclusions: Nerve enlargement was not observed in the present study in advanced UN. A reduced nerve CSA observed in the sural nerve suggests an axonal loss associated with long-term HD in ESKD. During clinical workup of an acute disease of the peripheral nervous system in ESKD patients, nerve enlargement might be attributable to other causes than chronic UN.
(© 2024 The Authors. Journal of Neuroimaging published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.)
Databáze: MEDLINE
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