КЛИНИКО-НЕЙРОФИЗИОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА ПОЛИНЕЙРОПАТИЙ ПРИ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЯХ ПОЧЕК

This article presents the results of an in-depth clinical and pathogenetic study of peripheral nervous system involvement in patients with stage III–IV chronic kidney disease (CKD). The prevalence, clinical variants, and severity of polyneuropathy were analyzed with consideration of disease etiology, the stage of renal dysfunction, and neurophysiological characteristics. The study was based on a comprehensive examination of 100 patients with stage III–IV CKD, including individuals with diabetic and non-diabetic forms of the disease, as well as a control group of apparently healthy subjects. It was established that the progression of CKD is accompanied by the development of systemic sensorimotor polyneuropathy characterized by reduced nerve conduction velocity, decreased M-response amplitude, and predominant involvement of the nerves of the lower extremities. The most pronounced neurophysiological and clinical changes were observed in patients with diabetic etiology of CKD. The obtained data confirm the leading role of uremic intoxication, metabolic disturbances, and microangiopathic changes in the pathogenesis of polyneuropathies in CKD and substantiate the need for early detection and comprehensive pathogenetic correction of peripheral neurological complications.