Chronic Kidney Disease and Polyneuropathy

Pathophysiological Mechanisms

• Electrolyte imbalances, particularly abnormal potassium levels, contribute to nerve dysfunction in CKD patients, according to the American College of Cardiology 1
• Uremia and hyperparathyroidism associated with CKD lead to myocardial and potentially nerve fibrosis, which can be arrhythmogenic and neuropathogenic, as reported by the American College of Cardiology 1
• Dysregulation of intracellular calcium flux affects nerve conduction and function in CKD patients, as noted by the American College of Cardiology 1
• CKD creates a prothrombotic state with alterations in hemostatic systems that can affect microcirculation to nerves, according to the American College of Cardiology 2
• Activation of the renin-angiotensin-aldosterone system (RAAS) in CKD contributes to vascular remodeling and tissue fibrosis, potentially affecting nerve blood supply, as reported by the American College of Cardiology 2
• Heightened sympathetic activity common in CKD contributes to autonomic imbalance, as noted by the American College of Cardiology 1