Diabetic peripheral neuropathy as measured using a point-of-care sural nerve conduction device is associated with a faster decline in renal function in patients with type 2 diabetes.

AIMS/

INTRODUCTION

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and may be linked to renal function decline. However, the prognostic value of point-of-care nerve conduction devices such as DPN-Check® for renal outcomes remains unclear.

MATERIALS AND

METHODS

We conducted a single-center retrospective observational study of 403 patients with diabetes (median follow-up 2.9 years) at Tokyo Metropolitan Ohkubo Hospital. DPN was assessed by DPN-Check® (amplitude [AMP] <5 μV or nerve conduction velocity [NCV] <42 m/s) and simplified diagnostic criteria (SDC). The primary outcome was annual eGFR decline, calculated by the linear least squares method; rapid decliners were defined as those with a decline ≥5 mL/min/1.73 m2/year. Multivariate linear and logistic regression analyses were performed to identify independent associations.

RESULTS

Patients with DPN diagnosed with DPN-Check® had a greater annual eGFR decline than those without (-2.26 vs. -0.81 mL/min/1.73 m2/year, P < 0.001), whereas DPN diagnosed with SDC showed no association. In multivariate analysis, DPN diagnosed with DPN-Check® remained independently associated with faster eGFR decline (standardized β: -0.262, P < 0.001) and with rapid decliner status (odds ratio [OR]: 2.791, 95% confidence interval [CI]: 1.267-6.152, P = 0.011).

CONCLUSIONS

DPN diagnosed by DPN-Check® was independently associated with accelerated renal function decline in patients with T2DM, even after adjusting for albuminuria. DPN-Check® may help identify patients at high risk for end-stage kidney disease and guide earlier intervention for both neuropathy and kidney disease.