S G Shyam Lakshman1, P Ravikumar1, Giridhari Kar2, Dwijen Das3, Kallol Bhattacharjee3, Prithwiraj Bhattacharjee4. 1. Postgraduate Trainee, Department of General Medicine, Silchar Medical College , Silchar, Assam, India . 2. Professor, Department of General Medicine, Silchar Medical College , Silchar, Assam, India . 3. Associate Professor, Department of General Medicine, Silchar Medical College , Silchar, Assam, India . 4. Professor and Head, Department of General Medicine, Silchar Medical College , Silchar, Assam, India .
Abstract
INTRODUCTION: Globally, Chronic Kidney Disease (CKD) is a critical and rapidly growing health problem and also a major cause of mortality and morbidity. Neurological complications occur in all levels of the nervous system. Central nervous system complications include cerebrovascular accidents, posterior reversible encephalopathy syndrome, osmotic demyelization syndrome, cerebral infection and sinus vein thrombosis. Peripheral nervous system complications include polyneuropathy, mononeuropathy and carpal tunnel syndrome. Haemodialysis (HD) related neurological complications include dialysis disequilibrium syndrome, dementia and cerebrovascular accidents. AIM: To assess the neurological complications of CKD and to compare the various neurological complications in patients on HD with those not on HD. MATERIALS AND METHODS: Hundred patients with CKD were included in the study. They were categorized into two groups according to the stage of CKD and those with stage 3 or more were considered as cases and stage 2 or less as controls. The cases and controls were followed up during subsequent visits for neurological complications. RESULTS: This study comprised of 50 cases and 50 controls. Among 50 cases, males were 62% and females were 38% with male: female ratio was 1.6:1 and in controls, male: female ratio was 1.08:1. The maximum patients were in the age group of 51-60 years. The incidence of neurological complications was significantly higher in cases compared to controls and among people who underwent dialysis compared to those who were not. Headache was the most common complication both among cases and controls and as well as in people who were on HD. Stroke, seizures and altered sensorium were significantly associated with later stage of CKD. Cases underwent HD had significant association with headache, altered sensorium and stroke than those without HD but peripheral neuropathy and seizure did not show such association. CONCLUSION: The chances of development of neurological complications were significantly higher in late stages of CKD compared to early stages of CKD. Those neurological complications were more among people who underwent dialysis when compared to those not on maintenance HD.
INTRODUCTION: Globally, Chronic Kidney Disease (CKD) is a critical and rapidly growing health problem and also a major cause of mortality and morbidity. Neurological complications occur in all levels of the nervous system. Central nervous system complications include cerebrovascular accidents, posterior reversible encephalopathy syndrome, osmotic demyelization syndrome, cerebral infection and sinus vein thrombosis. Peripheral nervous system complications include polyneuropathy, mononeuropathy and carpal tunnel syndrome. Haemodialysis (HD) related neurological complications include dialysis disequilibrium syndrome, dementia and cerebrovascular accidents. AIM: To assess the neurological complications of CKD and to compare the various neurological complications in patients on HD with those not on HD. MATERIALS AND METHODS: Hundred patients with CKD were included in the study. They were categorized into two groups according to the stage of CKD and those with stage 3 or more were considered as cases and stage 2 or less as controls. The cases and controls were followed up during subsequent visits for neurological complications. RESULTS: This study comprised of 50 cases and 50 controls. Among 50 cases, males were 62% and females were 38% with male: female ratio was 1.6:1 and in controls, male: female ratio was 1.08:1. The maximum patients were in the age group of 51-60 years. The incidence of neurological complications was significantly higher in cases compared to controls and among people who underwent dialysis compared to those who were not. Headache was the most common complication both among cases and controls and as well as in people who were on HD. Stroke, seizures and altered sensorium were significantly associated with later stage of CKD. Cases underwent HD had significant association with headache, altered sensorium and stroke than those without HD but peripheral neuropathy and seizure did not show such association. CONCLUSION: The chances of development of neurological complications were significantly higher in late stages of CKD compared to early stages of CKD. Those neurological complications were more among people who underwent dialysis when compared to those not on maintenance HD.
Entities:
Keywords:
Dementia; Peripheral nervous system diseases; Renal dialysis; Stroke
Authors: Ajay K Singh; Youssef M K Farag; Bharati V Mittal; Kuyilan Karai Subramanian; Sai Ram Keithi Reddy; Vidya N Acharya; Alan F Almeida; Anil Channakeshavamurthy; H Sudarshan Ballal; Gaccione P; Rajan Issacs; Sanjiv Jasuja; Ashok L Kirpalani; Vijay Kher; Gopesh K Modi; Georgy Nainan; Jai Prakash; Devinder Singh Rana; Rajanna Sreedhara; Dilip Kumar Sinha; Shah Bharat V; Sham Sunder; Raj K Sharma; Sridevi Seetharam; Tatapudi Ravi Raju; Mohan M Rajapurkar Journal: BMC Nephrol Date: 2013-05-28 Impact factor: 2.388