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Chen X, Zhu X, Han P, Zhang Y, He M, Zhang Y, Liu J, Tang J, Zhang Y, Zheng Y, Zhang Z, Li M, Guo Q. Sarcopenia is associated with mild-to-moderate chronic kidney disease in Chinese community-dwelling older men but not in women. J Int Med Res 2022; 50:3000605221136683. [PMID: 36446755 PMCID: PMC9716608 DOI: 10.1177/03000605221136683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To determine whether a relationship exists between sarcopenia, including its individual components (muscle mass, muscle strength and gait speed), and mild-to-moderate chronic kidney disease (CKD) in Chinese older adults. METHODS This cross-sectional study comprised participants aged ≥60 years from Tianjin and Shanghai, China, who joined a national free physical examination program between 2014 and 2019, and consented to study inclusion. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (2019 version). Mild-to-moderate CKD was defined as estimated glomerular filtration rate (eGFR) between 45 ml/min/1.73 m2 and 60 ml/min/1.73 m2. RESULTS A total of 1627 participants were included (mean age, 69.32 ± 6.17 years; 43.8% male). Sarcopenia was significantly associated with mild-to-moderate CKD in men but not women. Among three physical performance components, slow gait speed (odds ratio 1.89, 95% confidence interval 1.38, 2.58) was associated with mild-to-moderate CKD in both men and women after adjusting for all other variables. CONCLUSIONS Sarcopenia was closely associated with mild-to-moderate CKD in older men, and slow gait speed was related to mild-to-moderate CKD in men and women. These findings may help guide better diagnosis and management of CKD in the context of slow gait speed, and facilitate earlier CKD detection and appropriate intervention in older adults.
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Affiliation(s)
- Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xiaoyan Zhu
- Department of Rehabilitation Medicine, Shanghai Herson Rehabilitation Hospital, Shanghai, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Mian He
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yuhui Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jinghuan Liu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jiawei Tang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yisong Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yaqing Zheng
- Department of Rehabilitation Medicine, Fujian Provincial Hospital, Fujian, China
| | - Ziwei Zhang
- Department of Rehabilitation Medicine, Fujian Provincial Hospital, Fujian, China
| | - Ming Li
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China,Qi Guo, Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China.
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Song P, Xu X, Zhao Y, Gu M, Chen X, Zhang H, Wu X, Yu C, Niu J, Ding W, Zhang S, Guo Q. Different stages of chronic kidney disease are associated with physical performance in adults over 60 years. Front Public Health 2022; 10:963913. [PMID: 36159314 PMCID: PMC9501662 DOI: 10.3389/fpubh.2022.963913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/10/2022] [Indexed: 01/24/2023] Open
Abstract
Objective The purpose of this study was to determine the association between different stages of chronic kidney disease (CKD) and sarcopenia and its components in the Chinese older population. Methods The study comprised of 2,213 participants aged ≥ 60 years (1,025 men; mean age: 70.7 years) recruited from Shanghai who were invited to participate in a comprehensive geriatric assessment. Sarcopenia was defined according to the AWGS 2019 consensus update on sarcopenia diagnosis criteria. The glomerular filtration rate (GFR) was estimated using the equation that originated from the CKD-EPI equation, the stages of CKD are classified according to the Kidney Disease-Improving Global Outcomes (KDIGO). Results The overall prevalence of sarcopenia was 19.0%, which increased with the severity of CKD. The prevalence of sarcopenia in patients with CKD 3-4 and kidney failure was significantly higher than that in normal and CKD 1-2 (p < 0.05). In logistic regression analysis model, compared with normal and CKD 1 patients, kidney failure was significantly associated with the increased risk of sarcopenia and low grip strength (p < 0.05); CKD 2, CKD 3-4 and kidney failure groups were significantly associated with an increased risk of low walking speed (p < 0.05), respectively; while the association between CKD and muscle mass was not shown. Conclusions In our study, only decreased physical performance, as represented by walking speed, was significantly associated with increased CKD severity. This may improve the evidence for the prevention and intervention of sarcopenia in patients with CKD.
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Affiliation(s)
- Peiyu Song
- Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China
| | - Xinghong Xu
- Shanghai Yongci Rehabilitation Hospital, Shanghai, China
| | - Yinjiao Zhao
- Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China
| | - Minghong Gu
- Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Hui Zhang
- Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China
| | - Xinze Wu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jianying Niu
- Department of Nephrology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wei Ding
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suhua Zhang
- Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China,Suhua Zhang
| | - Qi Guo
- Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China,Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China,*Correspondence: Qi Guo
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Anand U, Korchev Y, Anand P. The role of urea in neuronal degeneration and sensitization: An in vitro model of uremic neuropathy. Mol Pain 2020; 15:1744806919881038. [PMID: 31549574 PMCID: PMC6796209 DOI: 10.1177/1744806919881038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Uremic neuropathy commonly affects patients with chronic kidney disease, with
painful sensations in the feet, followed by numbness and weakness in the
legs and hands. The symptoms usually resolve following kidney
transplantation, but the mechanisms of uremic neuropathy and associated pain
symptoms remain unknown. As blood urea levels are elevated in patients with
chronic kidney disease, we examined the morphological and functional effects
of clinically observed levels of urea on sensory neurons. Methods Rat dorsal root ganglion neurons were treated with 10 or 50 mmol/L urea for
48 h, fixed and immunostained for PGP9.5 and βIII tubulin
immunofluorescence. Neurons were also immunostained for TRPV1, TRPM8 and
Gap43 expression, and the capsaicin sensitivity of urea- or vehicle-treated
neurons was determined. Results Urea-treated neurons had degenerating neurites with diminished PGP9.5
immunofluorescence, and swollen, retracted growth cones. βIII tubulin
appeared clumped after urea treatment. After 48 hours urea treatment,
neurite lengths were significantly reduced to 60 ± 2.6% (10 mmol/L,
**P < 0.01), and to 56.2 ± 3.3% (50 mmol/L, **P < 0.01), compared with
control neurons. Fewer neurons survived urea treatment, with 70.08 ± 13.3%
remaining after 10 mmol/L (*P < 0.05) and 61.49 ± 7.4% after 50 mmol/L
urea treatment (**P < 0.01), compared with controls. The proportion of
neurons expressing TRPV1 was reduced after urea treatment, but not TRPM8
expressing neurons. In functional studies, treatment with urea resulted in
dose-dependent neuronal sensitization. Capsaicin responses were
significantly increased to 115.29 ± 3.4% (10 mmol/L, **P < 0.01) and
125.3 ± 4.2% (50 mmol/L, **P < 0.01), compared with controls.
Sensitization due to urea was eliminated in the presence of the TRPV1
inhibitor SB705498, the mitogen-activated protein kinase kinase inhibitor
PD98059, the PI3 kinase inhibitor LY294002 and the TRPM8 inhibitor
N-(3-Aminopropyl)-2-[(3-methylphenyl)methoxy]-N-(2-thienylmethyl)benzamide
(AMTB hydrochloride). Conclusion Neurite degeneration and sensitization are consistent with uremic neuropathy
and provide a disease-relevant model to test new treatments.
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Affiliation(s)
- U Anand
- Peripheral Neuropathy Unit, Centre for Clinical Translation, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK.,Nanomedicine Research Laboratory, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Y Korchev
- Nanomedicine Research Laboratory, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - P Anand
- Peripheral Neuropathy Unit, Centre for Clinical Translation, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Hellberg M, Höglund P, Svensson P, Clyne N. Randomized Controlled Trial of Exercise in CKD-The RENEXC Study. Kidney Int Rep 2019; 4:963-976. [PMID: 31312771 PMCID: PMC6609793 DOI: 10.1016/j.ekir.2019.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/17/2019] [Accepted: 04/01/2019] [Indexed: 01/25/2023] Open
Abstract
Introduction Home-based, clinically feasible trials in non-dialysis-dependent patients with chronic kidney disease (CKD) are sparse. We compared the effects of 2 different exercise training programs on physical performance, and measured glomerular filtration rate (mGFR) and albuminuria level in patients with CKD stages 3 to 5. Methods This is a single-center, randomized controlled trial (RCT) comprising 151 patients (mGFR: 22 ± 8 ml/min per 1.73 m2; age 66 ± 14 years) randomized to either balance or strength training. Both groups were prescribed 30 minutes of exercise per day for 5 days per week for 12 months, comprising 60 minutes per week of endurance training and 90 minutes per week of either strength or balance exercises. The exercises were individually prescribed, and the intensity was monitored with Borg's rating of perceived exertion (RPE). Results There were no treatment differences for any of the primary outcomes measuring physical performance. The strength and balance groups showed significantly increased effect sizes after 12 months for the following: walking (31 m and 24 m, P < 0.001) and the 30-second sit-to-stand test (both: 1 time, P < 0.001); quadriceps strength (right/left: strength 1.2/0.8 kg*m, P < 0.003; balance 0.6/0.9, P < 0.01); functional reach (both: 2 cm, P < 0.01); and fine motor skills (open/closed eyes, right/left, both: between 0.3 and 4 seconds faster, P < 0.05). After 12 months, there was a significant treatment difference for albuminuria (P < 0.02), which decreased by 33% in the strength group. In both groups, mGFR declined by 1.8 ml/min per 1.73 m2. Conclusion Our primary hypothesis that strength training was superior to balance training was not confirmed. Within groups, 12 months of exercise training resulted in significant improvements in most measures of physical performance. Measured GFR declined similarly in the 2 groups. The strength group showed a significant decrease in albuminuria.
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Affiliation(s)
- Matthias Hellberg
- Department of Nephrology, Institution of Clinical Sciences Lund, Lund, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden.,Faculty of Medicine, Skåne University Hospital, Lund Sweden
| | - Peter Höglund
- Faculty of Medicine, Lund University, Lund, Sweden.,Faculty of Medicine, Skåne University Hospital, Lund Sweden.,Department of Clinical Chemistry and Pharmacology, Institution of Laboratory Medicine Lund, Lund, Sweden
| | - Philippa Svensson
- Department of Nephrology, Institution of Clinical Sciences Lund, Lund, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden.,Faculty of Medicine, Skåne University Hospital, Lund Sweden
| | - Naomi Clyne
- Department of Nephrology, Institution of Clinical Sciences Lund, Lund, Sweden.,Faculty of Medicine, Lund University, Lund, Sweden.,Faculty of Medicine, Skåne University Hospital, Lund Sweden
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5
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Sedaghat S, Darweesh SKL, Verlinden VJA, van der Geest JN, Dehghan A, Franco OH, Hoorn EJ, Ikram MA. Kidney function, gait pattern and fall in the general population: a cohort study. Nephrol Dial Transplant 2018; 33:2165-2172. [PMID: 29566168 DOI: 10.1093/ndt/gfy043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 01/08/2018] [Indexed: 11/14/2022] Open
Abstract
Background Gait disturbance is proposed as a mechanism for higher risk of fall in kidney disease patients. We investigated the association of kidney function with gait pattern in the general population and tested whether the association between impaired kidney function and fall is more pronounced in subjects with lower gait function. Methods We included 1430 participants (mean age: 60 years) from the Rotterdam Study. Kidney function was assessed using estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). We assessed global gait, gait velocity and seven independent gait domains: Rhythm, Phases, Variability, Pace, Tandem, Turning and Base of Support. Regression models adjusted for cardiometabolic and neurological factors were used. We evaluated whether participants with impaired kidney function and impaired gait fell more in the previous year. Results The study population had a median (interquartile range) ACR of 3.6 (2.5-6.2) mg/g and mean ± SD eGFR of 87.6 ± 15 mL/min/1.73 m2. Higher ACR and lower eGFR were associated with lower global gait score [per doubling of ACR: -0.10, 95% confidence interval (CI): -0.14 to -0.06, and per SD eGFR:-0.09, 95% CI: -0.14 to -0.03] and slower gait speed (ACR: -1.44 cm/s, CI: -2.12 to -0.76; eGFR: -1.55 cm/s, CI: -2.43 to -0.67). Worse kidney function was associated with lower scores in Variability domain. The association between impaired kidney function and history of fall was present only in participants with lower gait scores [odds ratio (95% CI): ACR: 1.34 (1.09-1.65); eGFR: 1.58 (1.07-2.33)]. Conclusions We observed a graded association between lower kidney function and impaired gait suggesting that individuals with decreased kidney function, even at an early stage, need to be evaluated for gait abnormalities and might benefit from fall prevention programmes.
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Affiliation(s)
- Sanaz Sedaghat
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sirwan K L Darweesh
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vincentius J A Verlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jos N van der Geest
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ewout J Hoorn
- Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mohammad Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
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6
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Issar T, Arnold R, Kwai NC, Pussell BA, Endre ZH, Poynten AM, Kiernan MC, Krishnan AV. The utility of the Total Neuropathy Score as an instrument to assess neuropathy severity in chronic kidney disease: A validation study. Clin Neurophysiol 2018; 129:889-894. [DOI: 10.1016/j.clinph.2018.02.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/14/2018] [Accepted: 02/04/2018] [Indexed: 10/17/2022]
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Abstract
Acute and chronic renal disease is prevalent in hospitalized and ambulatory patient populations. Most patients with acute or chronic renal disease exhibit some degree of neurologic dysfunction affecting the CNS, peripheral nervous system, or both. Neurologic manifestations may be a direct consequence of the uremic state or a consequence of renal replacement therapy. Early recognition of common central and peripheral nervous system dysfunction as it relates to renal disease may provide opportunities for therapeutic intervention and improved outcomes. This review will summarize the most frequently encountered manifestations of acute and chronic renal disease, organized with respect to their occurrence as a direct consequence of advanced renal dysfunction or renal replacement therapy.
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8
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Wei M, Zhu J, Wang N, Xue Q, Liu F, Hu B, Fang J, Zhang Y. Preliminary study of sural nerve morphological changes in uremic hemodialysis patients using 22-MHz high-frequency ultrasound. Muscle Nerve 2012; 46:937-42. [DOI: 10.1002/mus.23418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2012] [Indexed: 11/10/2022]
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9
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Giray S, Sagliker Y, Yildiz I, Halvaci I, Paylar N, Ocal F, Balal M, Ozkaynak PS, Paydas S, Sagliker C, Sagliker HS, Kiralp N, Adam SM, Esenturk M, Gocmez E, Taskapan H, Yuksekgonul M, Emir I, Guler T, Yakar H, Sekin O, Kayali E, Caliskan S, Eskiocak AF, Ogruk B, Guzelyurt T, Kurt C. Neurologic manifestations in Sagliker syndrome: uglifying human face appearance in severe and late secondary hyperparathyroidism in chronic renal failure patients. J Ren Nutr 2006; 16:233-6. [PMID: 16825026 DOI: 10.1053/j.jrn.2006.04.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients with chronic renal failure (CRF) often have signs and symptoms related to fluid and electrolyte disturbances, anemia, malnutrition, bone disease, and gastrointestinal problems. Vascular and neurologic impairment in particular remain an important source of morbidity and mortality in this vulnerable patient population. Sagliker syndrome is a novel syndrome that was recently described in 2004 in patients with CRF and severe and late secondary hyperparathyroidism who suffered from severe skull and facial bone changes, particularly from uglifying human face appearances and neuropsychiatric disorders. The goal of this study was to assess neuropsychiatric manifestations occurring in CRF patients with Sagliker syndrome. Four female and 8 male patients with CRF on regular dialysis at the hemodialysis units of the Internal Medicine Departments around southern Turkey participated in the study. All patients underwent a clinical neurologic examination performed by the same neurologist. Neuropsychiatric signs and symptoms were found in all cases. The results showed that the most frequent neurologic manifestations in CRF patients with Sagliker syndrome were headache, polyneuropathy, cranial neuropathy, fatigue, and psychiatric disorders.
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Affiliation(s)
- Semih Giray
- Baskent University Adana Teaching and Research Hospital Neurology Department, Adana, Turkey
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Brouns R, De Deyn PP. Neurological complications in renal failure: a review. Clin Neurol Neurosurg 2005; 107:1-16. [PMID: 15567546 DOI: 10.1016/j.clineuro.2004.07.012] [Citation(s) in RCA: 237] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2004] [Revised: 07/27/2004] [Accepted: 07/27/2004] [Indexed: 02/08/2023]
Abstract
Neurological complications whether due to the uremic state or its treatment, contribute largely to the morbidity and mortality in patients with renal failure. Despite continuous therapeutic advances, many neurological complications of uremia, like uremic encephalopathy, atherosclerosis, neuropathy and myopathy fail to fully respond to dialysis. Moreover, dialytic therapy or kidney transplantation may even induce neurological complications. Dialysis can directly or indirectly be associated with dialysis dementia, dysequilibrium syndrome, aggravation of atherosclerosis, cerebrovascular accidents due to ultrafiltration-related arterial hypotension, hypertensive encephalopathy, Wernicke's encephalopathy, hemorrhagic stroke, subdural hematoma, osmotic myelinolysis, opportunistic infections, intracranial hypertension and mononeuropathy. Renal transplantation itself can give rise to acute femoral neuropathy, rejection encephalopathy and neuropathy in graft versus host disease. The use of immunosuppressive drugs after renal transplantation can cause encephalopathy, movement disorders, opportunistic infections, neoplasms, myopathy and progression of atherosclerosis. We address the clinical, pathophysiological and therapeutical aspects of both central and peripheral nervous system complications in uremia.
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Affiliation(s)
- R Brouns
- Department of Neurology and Memory Clinic, Middelheim General Hospital, Antwerp, Belgium
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Forrest GP. Inpatient rehabilitation of patients requiring hemodialysis11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Arch Phys Med Rehabil 2004; 85:51-3. [PMID: 14970967 DOI: 10.1016/s0003-9993(03)00366-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the outcomes of patients who require hemodialysis and are admitted to an inpatient rehabilitation unit. DESIGN Retrospective review of the data of all admissions to an inpatient rehabilitation unit in 2001. SETTING University medical center. PARTICIPANTS All inpatient rehabilitation admissions in 2001 (N=531), including 497 patients who did not require hemodialysis and 34 who required hemodialysis. INTERVENTION A comprehensive rehabilitation program including physical therapy and occupational therapy. Speech and language therapy and rehabilitation psychology were provided when necessary. MAIN OUTCOME MEASURES Length of stay (LOS), change in total score on the FIM instrument, FIM efficiency, and place of discharge. RESULTS Admission and discharge FIM scores of the patients requiring hemodialysis were virtually identical to those of the other patients admitted to the unit. The average LOS of the hemodialysis patients was 5.4 days longer than that of the other patients, and, therefore, efficiency scores of the dialysis group were less than those of the other patients. The rate of discharge to the community did not differ significantly for the dialysis group. CONCLUSIONS Patients who require hemodialysis can benefit from rehabilitation services. Their improvement on the FIM instrument is comparable to that of other patients, but their LOS may be longer than that of other patients.
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