Annals of African medicine · 2026
Nerve Conduction Studies Correlation with Stage of Chronic Kidney Disease in Nondiabetic Chronic Kidney Disease Patients.
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Kanitkar Shubhangi, Reddy Kanamatareddy Sai Abhinav, Dhere Ira, Shivnitwar Sachin, Reddy M Sai Rohith
Аннотация
BACKGROUND: Peripheral neuropathy (PN), collectively termed uremic neuropathy, is one of the most prevalent neurological complications of chronic kidney disease (CKD). Nerve conduction studies (NCS) remain the gold standard for objective electrophysiological assessment of PN. There is limited Indian data examining NCS parameters across CKD stages in a nondiabetic population, where uremia can be studied without the confounding effect of hyperglycemia.
METHODOLOGY: This cross-sectional observational study enrolled 103 nondiabetic patients with CKD Stage 3, 4, and 5 according to Kidney Disease: Improving Global Outcomes classification at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. All patients underwent comprehensive bilateral NCS of motor nerves (median, ulnar, and peroneal) and sensory nerves (median and sural), with assessment of amplitude, distal latency, and conduction velocity.
RESULTS: The overall prevalence of PN by NCS was 74.8% (77/103). A perfectly stage-dependent neuropathy pattern was identified: normal NCS in all Stage 3 patients, pure axonal neuropathy in 71.9% of Stage 4 patients, and mixed-type neuropathy in 91.8% of Stage 5 patients ( P < 0.001). The sural nerve was the most severely affected, with a 73.4% amplitude reduction in Stage 5 ( F = 71.844, P < 0.001). All NCS parameters across all four nerves showed progressive deterioration with advancing CKD stage ( P < 0.001 for all).
CONCLUSION: PN by NCS is a prevalent (74.8%), progressive, and stage-dependent complication of nondiabetic CKD. The sural nerve is the most sensitive electrophysiological indicator. Routine NCS screening is recommended beginning at Stage 3 to detect subclinical neuropathy and enable early intervention.
METHODOLOGY: This cross-sectional observational study enrolled 103 nondiabetic patients with CKD Stage 3, 4, and 5 according to Kidney Disease: Improving Global Outcomes classification at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. All patients underwent comprehensive bilateral NCS of motor nerves (median, ulnar, and peroneal) and sensory nerves (median and sural), with assessment of amplitude, distal latency, and conduction velocity.
RESULTS: The overall prevalence of PN by NCS was 74.8% (77/103). A perfectly stage-dependent neuropathy pattern was identified: normal NCS in all Stage 3 patients, pure axonal neuropathy in 71.9% of Stage 4 patients, and mixed-type neuropathy in 91.8% of Stage 5 patients ( P < 0.001). The sural nerve was the most severely affected, with a 73.4% amplitude reduction in Stage 5 ( F = 71.844, P < 0.001). All NCS parameters across all four nerves showed progressive deterioration with advancing CKD stage ( P < 0.001 for all).
CONCLUSION: PN by NCS is a prevalent (74.8%), progressive, and stage-dependent complication of nondiabetic CKD. The sural nerve is the most sensitive electrophysiological indicator. Routine NCS screening is recommended beginning at Stage 3 to detect subclinical neuropathy and enable early intervention.