ORIGINAL PAPER Correlation between kidney and peripheral nerve functions in Type 2 diabetes Y.-R. Lai 1,2,3 , B.-C. Cheng 1,4 , C.-C. Huang 3 , W.-C. Chiu 5 , N.-W. Tsai 3 , J.-F. Chen 6 and C.-H. Lu 1,3,7,8 From the 1 Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, 2 Penghu Hospital, Ministry of Health and Welfare, Penghu City, Taiwan, 3 Departments of Neurology, Kaohsiumg Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 4 Divison of Nephrology, Kaohsiumg Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 5 Division of Rheumatology, Allergy, and Immunology, Kaohsiumg Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiumg, 6 Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 7 Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hosital, Chang Gung University College of Medicine, Kaohsiumg, Taiwan and 8 Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China Address correspondence to C.-H. Lu. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. email: chlu99@ms44.url.com.tw, chlu99@adm.cgmh.org.tw Summary Background: Although greater impairments in nerve functions parameters are most likely to occur with a lower kidney function, there is a paucity of information on the relationship between the kidney and peripheral nerve functions parame- ters in Type 2 diabetes. Aim: To address the impact of peripheral nerve functions in Type 2 diabetes patients in different stages of chronic kidney diseases (CKD). Design: This prospective study enrolled 238 patients with Type 2 diabetes at a tertiary medical center. Method: We designed composite amplitude scores of nerve conductions (CAS) as a measure of severity of peripheral neur- opathy (PN), and used estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) parameters to stage CKD in Type 2 diabetes patients. The intrapersonal mean, standard deviation and coefficient of variation of eGFR for 238 patients were obtained in the 3 years prior to the study. Results: The patients who had lower eGFR and higher UACR were older, with longer diabetes duration, a greater percentage of retinopathy and PN and higher CAS. Multiple linear regression analysis revealed that diabetes duration and eGFR were in- dependently associated with CAS, and a cut-off value of eGFR in the presence of PN was 65.3 ml/min/1.73 m 2 . Conclusion: We observed a close relationship between the severity of kidney and peripheral nerve function in patients with diabetes. If a patient’s eGFR value is below 65.3 ml/min/1.73 m 2 or the UACR value is above 98.6 mg/dl, caution is needed with the presence of PN even in diabetic patients who are asymptomatic. Received: 27 May 2019; Revised (in revised form): 11 September 2019 VC The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com 173 QJM: An International Journal of Medicine, 2020, 173–180 doi: 10.1093/qjmed/hcz249 Advance Access Publication Date: 4 October 2019 Original paper Downloaded from https://academic.oup.com/qjmed/article/113/3/173/5581417 by guest on 21 November 2023