ĐẶC ĐIỂM LÂM SÀNG VÀ ĐIỆN SINH LÝ THẦN KINH NGOẠI BIÊN Ở NGƯỜI BỆNH MẮC BỆNH THẬN MẠN CHƯA ĐIỀU TRỊ THAY THẾ THẬN TẠI TRUNG TÂM THẬN TIẾT NIỆU VÀ LỌC MÁU BỆNH VIỆN BẠCH MAI

Abstract

Background: Peripheral neuropathy is the most common neurological complication in patients with chronic kidney disease (CKD), significantly affecting quality of life. However, it is often overlooked due to its insidious progression and minimal symptoms in the early stages. This study aimed to evaluate the clinical and electrophysiological characteristics of peripheral neuropathy in CKD stage 3–5 patients who had not yet undergone renal replacement therapy at the Nephrology and Dialysis Center, Bach Mai Hospital. Methods: A cross-sectional descriptive study was conducted on 70 CKD patients (estimated glomerular filtration rate <60 ml/min) who had not received renal replacement therapy, recruited at the Nephrology and Dialysis Center, Bach Mai Hospital, from August 2024 to August 2025. Peripheral neuropathy was assessed through clinical neurological examination and nerve conduction studies. Results: Clinical signs of peripheral neuropathy were present in 50% of patients, most commonly subjective sensory disturbances (44.3%), objective sensory loss (34.3%), and reduced deep tendon reflexes (32.9%). No muscle weakness was observed. Electrophysiological abnormalities were detected in 87.1% of patients, predominantly involving sensory nerves and lower limbs, characterized mainly by reduced conduction amplitudes, consistent with axonal degeneration. Both electrophysiological changes and clinical symptoms increased with CKD stage, most markedly in stage 5. Conclusion: Nerve conduction studies can detect peripheral nerve damage even in the absence of clinical symptoms.