Shih-Yi Lin1,2, Cheng-Li Lin3,4, Wu-Huei Hsu1,5, Cheng-Chieh Lin1,6, Sui-Foon Lo7, Chia-Hung Kao1,8,9,10. 1. Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan. 2. Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 4. College of Medicine, China Medical University, Taichung, Taiwan. 5. Division of Pulmonary and Critical Care Medicine, China Medical University Hospital and China Medical University, Taichung, Taiwan. 6. Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. 7. Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan. 8. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. 9. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan. 10. Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: Whether patients with end-stage renal disease (ESRD) have a higher risk of idiopathic polyneuropathy (IPN) than those without ESRD remains unclear. We hypothesised that carpal tunnel syndrome (CTS) is a prodrome of IPN in patients with ESRD. METHODS: Data were collected from the Taiwan National Health Insurance research database (NHIRD) for the 2000-2011 period. Two matching strategies, age- and sex-matching and propensity matching, were used, which yielded 2596 age- and sex-matched patients with ESRD and 2210 propensity-matched patients with ESRD. The comparison cohort was chosen in a 1:4 ratio for the age- and sex-matched method and in a 1:1 ratio for the propensity-matching method. The primary outcome was the incidence of IPN. Cox proportional hazards modelling was used. RESULTS: In the age- and sex-matched cohort, the IPN incidence was 7.64 and 2.88 per 1000 person-years for the ESRD and controls cohorts, respectively. After we adjusted for age, sex, comorbidities and medications relative to controls, having ESRD was significantly associated with increased risk of IPN (hazard ratio [HR] = 2.45, 95% confidence interval [CI] = 1.76-3.41). Competing risk of death as sensitivity analysis revealed that having ESRD with CTS was still associated with higher risk of IPN than having CTS without ESRD (HR = 2.85, 95% CI = 1.87-4.34). CONCLUSION: Patients with ESRD with CTS had higher incidences of idiopathic peripheral neuropathy than those without ESRD with CTS.
BACKGROUND: Whether patients with end-stage renal disease (ESRD) have a higher risk of idiopathic polyneuropathy (IPN) than those without ESRD remains unclear. We hypothesised that carpal tunnel syndrome (CTS) is a prodrome of IPN in patients with ESRD. METHODS: Data were collected from the Taiwan National Health Insurance research database (NHIRD) for the 2000-2011 period. Two matching strategies, age- and sex-matching and propensity matching, were used, which yielded 2596 age- and sex-matched patients with ESRD and 2210 propensity-matched patients with ESRD. The comparison cohort was chosen in a 1:4 ratio for the age- and sex-matched method and in a 1:1 ratio for the propensity-matching method. The primary outcome was the incidence of IPN. Cox proportional hazards modelling was used. RESULTS: In the age- and sex-matched cohort, the IPN incidence was 7.64 and 2.88 per 1000 person-years for the ESRD and controls cohorts, respectively. After we adjusted for age, sex, comorbidities and medications relative to controls, having ESRD was significantly associated with increased risk of IPN (hazard ratio [HR] = 2.45, 95% confidence interval [CI] = 1.76-3.41). Competing risk of death as sensitivity analysis revealed that having ESRD with CTS was still associated with higher risk of IPN than having CTS without ESRD (HR = 2.85, 95% CI = 1.87-4.34). CONCLUSION:Patients with ESRD with CTS had higher incidences of idiopathic peripheral neuropathy than those without ESRD with CTS.