Kidney Failure
Kidney failure-related nerve damage
Chronic kidney or renal failure (uremia) occurs when the kidneys gradually fail to function properly. When the kidneys are impaired, fluids and waste products accumulate in the body. This accumulation is toxic for nerves, and in some cases, may cause peripheral neuropathy.
1/7
Kidney failure, also known as Chronic Kidney Disease (CKD), affects roughly 1 in 7 adults in the United States, meaning around 35.5 million people have it
90%
Up to 90% of people with chronic kidney disease experience the complication of PN
Toxins
The buildup of toxins in the blood due to impaired kidney function is thought to damage nerves, leading to neuropathy.
Many conditions can cause kidney failure; the most common are diabetes and high blood pressure.
Since many organs and systems within the body are affected by kidney failure and fluid retention, kidney failure causes a general state of ill health. Also, many complications may occur, including uremic neuropathy—a type of peripheral neuropathy that progresses slowly and may afflict 50% to 100% of people with chronic kidney disease.
Symptoms
(Not all symptoms and signs may be present)
- Pain, numbness, and tingling in the feet and legs
- Feeling of “pins and needles”
- Paradoxical heat sensation
- Restless leg syndrome
- Imbalance
- Cramps, muscle twitches, or increased pain sensation in the feet and legs
- Muscle weakness or reduced sensation may occur
Tests
(Not all evaluation and tests may be necessary)
- Neurological exam
- Electromyography
- Nerve conduction test
- Blood tests including tests for renal function
Treatments
(Not all treatments and therapies may be indicated)
For relief of uremic neuropathy:
- Take safety measures to compensate for loss of sensation
- Dialysis
- Kidney transplant
Today, doctors are exploring a link between pre-diabetes (also known as impaired glucose tolerance or IGT) and peripheral neuropathy. Approximately 10% of adults in America have what is being called “pre-diabetes” or “borderline diabetes”—a condition where the body has higher than normal blood sugar levels, but not high enough to be diagnosed as true diabetes. If left untreated, people with pre-diabetes are at risk of developing type 2 diabetes, heart disease, and nerve damage (which could result in peripheral neuropathy.)
People with pre-diabetes or IGT can significantly reduce their risk of developing type 2 diabetes through diet, exercise and learning to control their blood sugar levels.
Symptoms
(Not all symptoms and signs may be present)
People with IGT often have no symptoms. People who actually have diabetes—and who therefore are at greater risk of developing peripheral neuropathy—often don’t realize it because the symptoms of diabetes come on so gradually. Pre Diabetic symptoms and its complications include:
- Frequent urination
- Blurred vision
- Constant thirst
- Fatigue
- Frequent infections
- Cuts and bruises that heal slowly
- Tingling or numbness in the hands or feet
Tests
(Not all evaluation and tests may be necessary)
To test for pre-diabetes:
- Blood test
- Oral glucose tolerance test
Treatments
(Not all treatments and therapies may be indicated)
- Over-the-counter pain medication for mild pain
- Take safety measures to compensate for loss of sensation.
- Ask your doctor about special therapeutic shoes (which may be covered by Medicare and other insurance).
The first sign of diabetic neuropathy is usually numbness, tingling or pain in the feet, legs or hands.
Over a period of several years, the neuropathy may lead to muscle weakness in the feet and a loss of reflexes, especially around the ankle.
As the nerve damage increases, the loss of sensation in the feet can reduce a person’s ability to detect temperature or to notice pain. Because the person can no longer notice when his/her feet become injured, people with diabetic neuropathy are more likely to develop foot problems such as skin lesions and ulcers that may become infected.
Diabetic neuropathy may suddenly flare up and affect a specific nerve or group of nerves. When this occurs, the result may be weakness and muscle atrophy in various parts of the body, such as involvement of the eye muscles or eyelid (e.g., causing double vision or a drooping eyelid) or thigh muscles. Alternatively, neuropathy caused by diabetes may slowly progress over time. It also can interfere with the normal functioning of the digestive system and sexual organs.
Symptoms
(Not all symptoms and signs may be present)
- Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
- Indigestion, nausea, or vomiting
- Diarrhea or constipation
- Dizziness or faintness due to a drop in blood pressure especially when rising to a standing position
- Problems with urination
- Erectile dysfunction (impotence) or vaginal dryness
Tests
(Not all evaluation and tests may be necessary)
- Comprehensive foot exam
- Physical examination
- Neurological exam
- Electromyography
- Nerve conduction velocity test
- Quantitive sensory testing (QST)
- Nerve or skin biopsy
- Blood studies (to verify diabetes (e.g., HbA1C) and to rule out other potential causes)
Treatments
(Not all treatments and therapies may be indicated)
The goal of treatment for diabetic neuropathy is to relieve discomfort and to prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet.
- Over-the-counter pain medication for mild pain
- For severe pain, take over-the-counter pain medication or prescription drugs used for peripheral neuropathy, on a regular basis—rather than waiting until nighttime when symptoms can become more severe
- Keep blood sugar levels in normal range
- Get regular exercise
- Maintain a healthy weight
- Antidepressants (for pain relief)
- Foot care: inspect your feet daily for injuries
- Special Therapeutic shoes (which may be covered by Medicare and other insurance)
- Take safety measures to compensate for loss of sensation
Resource library
Read our newsletter and explore educational brochures to help expand your knowledge of peripheral neuropathy.
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