| Skin denervation and its clinical significance in late-stage chronic kidney disease. | |
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MedLine Citation:
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PMID: 21320986 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the skin innervation and its clinical significance in late-stage chronic kidney disease (CKD). DESIGN: Case series. SETTING: National Taiwan University Hospital, Taipei, Taiwan. Patients Forty consecutive nondiabetic patients with late-stage CKD (14 female and 26 male; mean [SD] age, 60.7 [12.3] years), including 2 cases with stage 3 CKD, 6 with stage 4 CKD, and 32 with stage 5 CKD, ie, end-stage kidney disease. INTERVENTIONS: Clinical evaluation of neurological deficits, nerve conduction study, autonomic function tests, and a 3-mm-diameter skin biopsy specimen taken from the distal leg. MAIN OUTCOME MEASURES: Quantitation of epidermal innervation, parameters of nerve conduction study, R-R interval variability, and sympathetic skin response. RESULTS: Clinically, 21 patients (52.5%) were symptomatic with paresthesia over the limbs or autonomic symptoms. The intraepidermal nerve fiber (IENF) density was markedly reduced in patients with CKD compared with age- and sex-matched controls (mean [SD], 2.8 [2.0] vs 8.6 [2.8] fibers/mm; P < .001). Skin denervation was observed in 27 patients (67.5%). Fifteen patients (37.5%) had abnormalities on nerve conduction studies, and 29 patients (72.5%) had abnormal results on autonomic function tests. By analysis with multiple regression models, the IENF density was negatively correlated with the duration of renal disease (P = .02). Additionally, the R-R interval variability at rest was linearly correlated with the IENF density (P = .02) and the absence of sympathetic skin responses at the soles was associated with reduced IENF density (P = .03). CONCLUSIONS: Small-fiber sensory and autonomic neuropathies constitute the major form of neuropathy in late-stage CKD. Furthermore, skin denervation was associated with the duration of renal disease. |
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Authors:
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Chi-Chao Chao; Vin-Cent Wu; Chun-Hsiang Tan; Yi-Mei Wang; Ming-Tsung Tseng; Pei-Chen Wu; Yea-Huey Lin; Whei-Min Lin; Kwan-Dun Wu; Sung-Tsang Hsieh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of neurology Volume: 68 ISSN: 1538-3687 ISO Abbreviation: Arch. Neurol. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372436 Medline TA: Arch Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 200-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurology, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei 10002, Taiwan. shsieh@ntu.edu.tw. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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