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Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1264-1272

Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India.

We aimed to study the correlation of measurable uremic toxins with electrophysiological parameters of uremic polyneuropathy in chronic kidney disease (CKD) patients. This study was conducted between January 2018 and December 2018, 40 CKD patients on hemodialysis (HD) and 40 controls were included in the present study. Prevalence of peripheral neuropathy in CKD patients was 50% clinically and 65% of patients found to have neuropathy by electrophysiological study. Read More

Kidney Int Rep 2022 Mar 21;7(3):381-388. Epub 2021 Dec 21.

Transversal Nutrition Unit, Endocrinology-Diabetes-Nutrition Department, University Hospital of Montpellier, Montpellier, France.

Diabetic foot ulcer (DFU) and chronic kidney disease (CKD) are 2 significant complications of diabetes mellitus (DM). Up to 40% of patients with DM are expected to also develop CKD, and 19% to 34% will suffer from DFU during their lifetimes. However, data on the link between podiatric risk and the extent of CKD are scarce. Read More

Saudi J Kidney Dis Transpl 2021 Jul-Aug;32(4):1146-1151

Department of Internal Medicine, Nephrology Division, King Fahd Hospital of the University, Al Khobar, Saudi Arabia.

Cardiovascular diseases are the main cause of morbidity and mortality in end-stage renal disease (ESRD) patients. Cardiac arrhythmias are prevalent in patients undergoing hemodialysis (HD), however, dialysis treatment per se can be considered as an arrhythmogenic stimulus. Uremic patients are characterized by a "pro-arrhythmic substrate" because of the high prevalence of ischemic heart disease, left ventricular hypertrophy, and autonomic neuropathy. Read More

Antioxidants (Basel) 2022 Feb 16;11(2). Epub 2022 Feb 16.

Department of Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

Kidney disease patients may have concurrent chronic kidney disease-associated mineral bone disorder and hypertension. Cardiovascular disease (CVD) and neuropathy occur due to kidney failure-induced accumulation of uremic toxins in the body. Indoxyl sulfate (IS), a product of indole metabolism in the liver, is produced from tryptophan by the intestinal flora and is ultimately excreted through the kidneys. Read More

Muscle Nerve 2022 May 23;65(5):603-607. Epub 2022 Feb 23.

Prince of Wales Clinical School, UNSW, Sydney, New South Wales, Australia.

Introduction/aims: Sonographic alterations of peripheral nerves in pre-dialytic kidney disease are yet to be determined. We aimed to assess peripheral nerve cross-sectional area (CSA) and intraneural blood flow in patients with pre-dialytic chronic kidney disease (CKD) and diabetic kidney disease (DKD).

Methods: Subjects with CKD (n = 20) or DKD (n = 20) underwent ultrasound to assess CSA of the median and tibial nerves as well as intraneural blood flow of the median nerve. Read More

Rev Med Suisse 2022 Jan;18(764-5):45-50

Service de néphrologie, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.

Major advances in the treatment of nondiabetic chronic nephropathy and ANCA associated-renal vasculitis were published within the past two years. A new formula for assessing GFR was developed that does not take ethnicity into account. For hemodialysis patients, hemodiafiltration does not diminish uremic neuropathy. Read More

Clin Kidney J 2021 Dec 24;14(Suppl 3):i23-i31. Epub 2021 Dec 24.

Department of Internal Medicine, Division of Nephrology, Hypertension and Autoimmune Disorders, Alb-Fils Kliniken, Göppingen, Germany.

For decades, itch related to chronic kidney disease (CKDaP) has been a clinical problem, but the aetiology and pathophysiology of CKDaP are still not yet fully understood-currently the underlying pathophysiological mechanisms are thought to be multifactorial. As new therapeutic targets have recently been identified and clinical trials have shown promising results, our current understanding of the interrelationships has expanded significantly. Here we review the pathophysiology and recent findings on modulation and sensitization of itch contributing to the development of CKDaP, covering hypothesis regarding immune system dysfunction, metabolic changes, uremic toxin deposition, peripheral neuropathy and imbalances in the endogenous opioid system. Read More

EMBO Mol Med 2022 01 29;14(1):e14678. Epub 2021 Nov 29.

Infectious Disease Research Center, Korea Research Institute of Bioscience & Biotechnology (KRIBB), Daejeon, Korea.

Shiga toxins (Stxs) produced by enterohemorrhagic Escherichia coli (EHEC) are the major virulence factors responsible for hemorrhagic colitis, which can lead to life-threatening systemic complications including acute renal failure (hemolytic uremic syndrome) and neuropathy. Here, we report that O-GlcNAcylation, a type of post-translational modification, was acutely increased upon induction of endoplasmic reticulum (ER) stress in host cells by Stxs. Suppression of the abnormal Stx-mediated increase in O-GlcNAcylation effectively inhibited apoptotic and inflammatory responses in Stx-susceptible cells. Read More

Nephrol Ther 2021 Dec 13;17(7):488-495. Epub 2021 Oct 13.

UNICAEN, néphrologie, Normandie université, CHU de Caen Normandie, 14000 Caen, France; UNICAEN, UFR de médecine, Normandie Université, 2, rue des Rochambelles, 14032 Caen cedex, France; ANTICIPE U1086 Inserm-UCN, centre François-Baclesse, 14000 Caen, France.

Pruritus associated with chronic kidney disease is a frequent and disabling symptom in patients with severe chronic kidney disease treated by dialysis. It is associated with a poor quality of life, an increased risk of comorbidities and even mortality. Nevertheless, its prevalence is underestimated by nephrologists. Read More

Clin J Am Soc Nephrol 2021 09;16(9):1303-1305

Amsterdam UMC, Department of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.

Clin J Am Soc Nephrol 2021 09 7;16(9):1365-1375. Epub 2021 Jul 7.

Department of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia.

Background And Objectives: Neuropathy is a common complication of kidney disease that lacks proven disease-modifying treatments. Hemodiafiltration improves clearance of uremic toxins and is associated with better nerve function than hemodialysis. We aimed to determine whether hemodiafiltration reduces the progression of neuropathy in people receiving hemodialysis. Read More

Int J Mol Sci 2021 May 5;22(9). Epub 2021 May 5.

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

Diabetic neuropathy (DN), the most common chronic and progressive complication of diabetes mellitus (DM), strongly affects patients' quality of life. DN could be present as peripheral, autonomous or, clinically also relevant, uremic neuropathy. The etiopathogenesis of DN is multifactorial, and genetic components play a role both in its occurrence and clinical course. Read More

Toxics 2021 Apr 29;9(5). Epub 2021 Apr 29.

Key Laboratory of Modern Toxicology of Shenzhen, Shenzhen Medical Key Subject of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.

The peripheral (axonal) neuropathy associated with repeated exposure to aliphatic and aromatic solvents that form protein-reactive γ-diketones shares some clinical and neuropathological features with certain metabolic neuropathies, including type-II diabetic neuropathy and uremic neuropathy, and with the largely sub-clinical nerve damage associated with old age. These conditions may be linked by metabolites that adduct and cross-link neuroproteins required for the maintenance of axonal transport and nerve fiber integrity in the peripheral and central nervous system. Read More

J Stroke Cerebrovasc Dis 2021 Sep 16;30(9):105652. Epub 2021 Feb 16.

University of California, Irvine, 101 The City Drive South, Bldg 3, Rt. 88, Irvine, CA 92697, United States.

Sleep apnea is a condition with significant health risks and increased risk of mortality and is prevalent in patients with chronic kidney disease. This paper describes the detrimental cardiovascular sequelae of sleep-disordered breathing and explores the bidirectional relationship between chronic kidney disease and obstructive sleep apnea. Obstructive sleep apnea-related hypoxia produces a range of harmful systemic effects including oxidative stress, inflammation, and sympathetic activation that collectively worsen the progression of renal disease. Read More

Front Pediatr 2020 16;8:570708. Epub 2020 Nov 16.

Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.

Patients with chronic kidney disease (CKD) on maintenance hemodialysis frequently present with neurological complications. These complications include peripheral neuropathy, encephalopathy, and stroke. To detect the prevalence of neurological manifestations and complications in children with CKD through neurophysiological and neuro-radiological findings. Read More

Saudi J Kidney Dis Transpl 2020 Sep-Oct;31(5):1106-1109

Department of Nephrology, Government Stanley Medical College, Chennai, Tamil Nadu, India.

A 28-year-old male, 10 years post live-related renal transplant with stable graft function of 1.4 mg/dL, presented with complaints of loss of appetite and vomiting for three days. On evaluation, he was found to have significant graft dysfunction with a creatinine of 10. Read More

J Stroke Cerebrovasc Dis 2021 Sep 14;30(9):105461. Epub 2020 Nov 14.

Division of Nephrology, Hypertension and Kidney Transplantation, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, 101 The City Drive South, City Tower, Suite 400, Orange, CA 92868, USA. Electronic address:

Objectives: Cerebrovascular disease has increasingly been linked to overall vascular health. Pathologic conditions like diabetes, hypertension, and kidney disease have been shown to affect brain health and cerebrovascular and nervous systems. Acute kidney injury (AKI) and chronic Kidney Disease (CKD) represent a variety of vascular insults that can adversely affect cerebral health. Read More

J Int Med Res 2020 Jul;48(7):300060520933797

Department of Biological Science, National Sun Yat-Sen University, Kaohsiung.

Objective: Cardiovascular autonomic neuropathy is highly prevalent in patients with end-stage renal disease (ESRD), and it has a high fatality rate. This study aimed to determine whether peritoneal dialysis (PD) improves cardiovascular autonomic function (CAF) and decreases protein-bound uremic toxin (indoxyl sulfate [IS], p-cresyl sulfate [PCS]) levels.

Methods: IS and PCS levels, and parameters of CAF (heart rate response to deep breathing [HR_DB], the Valsalva ratio, baroreflex sensitivity, and the frequency domain) were prospectively evaluated in 26 patients with ESRD undergoing PD at two time points (pre-PD and 6 months post-PD). Read More

Dis Markers 2020 19;2020:1694218. Epub 2020 May 19.

Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Background: Peripheral neuropathy is a common neurological complication in uremic patients, and quantitative sensory testing (QST) is effective for diagnosis of small fiber neuropathy. Malnutrition and arterial stiffness are prevalent in patients undergoing hemodialysis (HD). The associations of small fiber neuropathy with nutritional status and arterial stiffness remain uncertain in maintenance HD patients. Read More

Ann Med Surg (Lond) 2020 Jul 16;55:107-110. Epub 2020 May 16.

Urologist, Duhok Directorate General of Health, Kurdistan Region, Iraq.

Introduction: Sexual dysfunction is a common problem in patients with chronic kidney disease. Disturbances in sexual function are noticed in early stages of chronic kidney diseases and deteriorate further as renal function declines. This is due to uremic effects, comorbid illness, anemia, hormonal disturbances, autonomic neuropathy, vascular diseases, hyperparathyroidism, hyperprolactinemia, side effects of medications, and psychosocial factors. Read More

Clin Rheumatol 2020 Feb 23;39(2):541-546. Epub 2019 Nov 23.

Sorbonne Université, Service de médecine interne, DHU i2B AP-HP, Hôpital Saint Antoine, 75012, Paris, France.

Transfusion-related acute lung injury (TRALI), defined as the onset of acute respiratory distress after blood transfusion, is a rare complication which is a leading cause of transfusion related-mortality. In this retrospective study, we report the French nationwide experience of intravenous immunoglobulin (IVIG)-related TRALI, with a literature review and analysis of management and outcome of this rare condition. With the pharmacovigilance services, we conducted a retrospective multicenter study in the French network of intensive care units with TRALI concomitant to IVIG use and pooled with data from a literature review. Read More

Medicine (Baltimore) 2019 Sep;98(39):e17232

Department of Ophthalmology.

Rationale: To report a rare case of severe atypical hemolytic-uremic syndrome (HUS) in a patient who presented with vitreous hemorrhage and tractional retinal detachment (TRD) in both eyes. To our knowledge, this is the first reported case of atypical HUS complicated with bilateral TRD in the literature.

Patient Concerns: A 20-year-old man with atypical HUS demonstrated bilateral visual acuity of hand motion at 30 cm. Read More

J Assoc Physicians India 2019 Aug;67(8):90-91

Assistant Professor, JLN Medical College, Ajmer, Rajasthan.

A 55 yr old diabetic lady suffered a posterior wall STEMI. She developed Contrast induced nephropathy following coronary angiography. Acute fulminant uremic neuropathy was precipitated which initially mimicked Guillan Barre Syndrome, hence reported. Read More

Mol Pain 2019 Jan-Dec;15:1744806919881038

Peripheral Neuropathy Unit, Centre for Clinical Translation, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK.

Clin Neurophysiol 2019 11 22;130(11):2088-2095. Epub 2019 Aug 22.

Prince of Wales Clinical School, UNSW Sydney, NSW 2031, Australia. Electronic address:

Objective: Chronic kidney disease (CKD) caused by diabetes is known as diabetic kidney disease (DKD). The present study aimed to examine the underlying mechanisms of axonal dysfunction and features of neuropathy in DKD compared to CKD and type 2 diabetes (T2DM) alone.

Methods: Patients with DKD (n = 30), CKD (n = 28) or T2DM (n = 40) and healthy controls (n = 41) underwent nerve excitability assessments to examine axonal function. Read More

J Assoc Physicians India 2018 Jun;66(6):31-37

Professor of Neurology, SVIMS, Tirupati, Andhra Pradesh.

Objective: To study the prevalence, clinical features, electrophysiological features and severity of peripheral neuropathy in chronic kidney disease (CKD) patients.

Methods: Between May 2015 and December 2016, 200 CKD patients and 25 controls were assessed prospectively.

Results: Prevalence of peripheral neuropathy in CKD patients was 50% based on clinical symptoms and 89% based on electrophysiological studies. Read More

Case Rep Med 2019 3;2019:4172395. Epub 2019 Apr 3.

Teaching (General) Hospital Kandy, Kandy, Sri Lanka.

Envenomations by hump-nosed pit vipers (HNVs) are frequent in Sri Lanka and in South India. Until recently, HNV was considered a moderately venomous snake. Here, we report a case of a previously healthy female developing all the known serious complications, plus some previously unreported complications following a HNV envenomation. Read More

Rev Assoc Med Bras (1992) 2019 Mar 11;65(3):469-474. Epub 2019 Apr 11.

Department of Integrated Clinical Discussions, ABC Medical School, Santo André, SP, Brasil.

Introduction: Peripheral neuropathy is a disorder that affects the cell body, axon or myelin of motor or peripheral sensory neurons and occurs in 60-100% of patients who are submitted to dialysis due to chronic kidney disease. Uremic neuropathy (UN) is attributed to the accumulation of organic waste, evident in patients with reduced glomerular filtration rate.

Objectives: This review aims to make clinical characteristics of uremic neuropathy evident enabling early diagnosis and treatment. Read More

Rev Assoc Med Bras (1992) 2019 Feb;65(2):281-286

Department of Integrated Clinical Discussions, ABC Medical School, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil.

Introduction: Peripheral neuropathy is a disorder that affects the cell body, axon or myelin of motor or peripheral sensory neurons and occurs in 60-100% of patients who are submitted to dialysis due to chronic kidney disease. Uremic neuropathy is attributed to the accumulation of organic waste, evident in patients with reduced glomerular filtration rate.

Objectives: This review aims to make clinical characteristics of uremic neuropathy evident enabling early diagnosis and treatment. Read More

Expert Rev Clin Pharmacol 2019 Jan 11;12(1):61-90. Epub 2019 Jan 11.

a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt.

: Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic, and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD. Read More