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Kidney Week

Abstract: TH-PO328

Vibration Perception Threshold as a Measure of Peripheral Neuropathy in Dialysis Patients: A Pilot Project

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Dedhia, Paras, Apex Kidney Care, Mumbai, India
  • Jasani, Rachana H., Apex Kidney Care, Mumbai, India
  • Billa, Viswanath, Bombay Hospital, Mumbai, India
  • Kothari, J., Apex Kidney Care, Mumbai, India
  • Bichu, Shrirang, Bombay Hospital Near Liberty Theater New Marine Lines, Mumbai, India
  • Kumar, Rajesh B., Apex Kidney Care, Mumbai, India
Background

Dialysis patients are at increased risk of fall due to neuropathy and myopathy. Also, significant percentages of dialysis patients are diabetic; making them vulnerable to neuropathy, foot ulcers and fall.

Methods

Vibration perception threshold (VPT) was measured by handheld digital biothesiometer in prevalent dialysis patients. The biothesiometer probe, which vibrates at amplitude proportional to the square of the applied voltage, was applied perpendicular to the test site. VPT value was defined as the voltage level at which subject first felt vibration sense. Measurements were taken at 6 points of plantar aspects of both feet at great toe, 1st metatarsal, 3rd metatarsal, 5th metatarsal, instep and heel. Average of these 6 points was further graded as normal (<15 volts), mild (16-20 volts), moderate (21-25 volts) and severe (>26 volts). All patients were on thrice a week hemodialysis.

Results

Of the 304 subjects, 59.5% were males. Average age was 51.1± 14.1 years and average dialysis vintage was 4.6 ± 3.8 years. 65 % subjects had hypertension, 31.9% had diabetes, 13% subjects had ischemic heart disease. VPT was found to be normal in 41.1%, mild impairment of VPT in 21.3%, moderate in 11.1% and severe impairment in 24.6% of subjects.

Conclusion

Moderate to severe vibration perception threshold impairment was found in 1-in-3 dialysis patients. This calls for quality improvement program to assess prevalence of neuroapthy and to decrease the burden of morbidities and falls.