Health-related quality of life in patients with cryptogenic polyneuropathy compared with the general population

PURPOSE

To evaluate the quality of life (QOL) in patients with cryptogenic polyneuropathy.

METHOD

Two validated instruments (SF-36 and EQ-5D) were sent to 86 patients with a 72% response rate (44 men, 18 women). As reference, 2721 individuals (1292 men, 1429 women; 59% response rate) from the general population responded to the same QOL instruments.

RESULTS

Compared to the general population, QOL was significantly more affected in patients with polyneuropathy concerning motor functions, with 42% of the patients reporting problems with walking, 7% having difficulties with washing and dressing, and 31% having problems with usual activities (work, study, household work, and family or leisure activities). The EQ-5D results showed that 85% of the patients were suffering from pain compared to 56% of the general population. Mental health was preserved among patients with polyneuropathy. Mobility was declining with increasing age in patients, but was not affected by disease duration.

CONCLUSIONS

Our study showed that patients with cryptogenic polyneuropathy have a lower QOL compared to the general population, although mental health scores did not differ between the groups. This information may be helpful when explaining the disease and its impact on newly diagnosed patients.

Polyneuropathy in Diabetic and Nondiabetic Patients on Capd: Is There an Association with HRQOL?

Background

It is well known that patients with uremia, as well as patients with diabetes mellitus, develop polyneuropathy.

Objectives

The signs of polyneuropathy in diabetic and nondiabetic patients on continuous ambulatory peritoneal dialysis (CAPD) and their relation with age, duration of dialysis, biochemical parameters, dialysis adequacy, and health-related quality of life (HRQOL) were analyzed in the present study.

Patients and Methods

65 CAPD patients (37 men, age 29 – 85 years, duration on dialysis 3 months to 14 years) were divided into two groups: group 1 was comprised of 20 diabetic patients (mean age 50.1 ± 13.2 years); group 2 was comprised of 45 nondiabetic patients (mean age 62.3 ± 9.7 years). Biochemical parameters, dialysis adequacy, and clinical signs were determined. Motor conduction velocity on the peroneal and tibial nerves and sensitive conduction velocity on the sural nerve were measured. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was used to measure the CAPD patients’ self-assessment of functioning and well-being using 4 component scores: physical component summary (PCS), mental component summary (MCS), kidney disease target issues, and patient satisfaction.

Results

Subjective symptoms were more intense in the diabetic patients and correlated with changes in peroneal and tibial distal motor latency (DML). Diabetic patients were significantly younger, had lower creatinine and higher glucose levels, and all analyzed pathological neurophysiological parameters were higher. Nondiabetic patients had prolonged latency of the F-wave on the peroneal nerve and the tibial nerve and reduced sensitive conduction velocity on the sural nerve. Significant correlations were found between the analyzed neurophysiological parameters and duration of dialysis and diabetes, glucose concentration, and dialysis adequacy in diabetic patients, and between neurophysiological parameters and age and dialysis adequacy in nondiabetic patients. Analysis of the 4 component scores of the KDQOL-SF revealed that diabetic patients had significantly better scores for PCS and MCS, which can be explained by their younger age. Patient satisfaction was worse in diabetic patients and correlated with duration of diabetes. In addition, significant correlations were established between PCS, MCS, and tibial DML (late neuropathic changes) in diabetic patients, and between MCS and tibial F-wave (early neuropathic changes) in nondiabetic patients.

Conclusion

Polyneuropathy was significantly worse in diabetic than in nondiabetic patients on CAPD. DML on the tibial nerve correlated with glucose concentration, dialysis adequacy, PCS, and MCS in diabetic patients, whereas in nondiabetic patients, dialysis adequacy and azotemia correlated with F-waves on the peroneal nerve and the tibial nerve but MCS only with F-wave on the tibial nerve.

Charcot arthropathy risk elevation in the obese diabetic population

PURPOSE

To examine the association of obesity, peripheral neuropathy, and other risk factors with the Charcot arthropathy incidence rate in a large diabetic population.

METHODS

The Department of Veterans Affairs inpatient and outpatient administrative datasets were used to identify persons with diabetes in 2003. Logistic regressions were used to model the likelihood of a person developing Charcot arthropathy as a function of individual characteristics, obesity, peripheral neuropathy, diabetic control, and comorbidities.

RESULTS

Of Veterans Affairs users with diabetes, 652 (0.12%) were newly diagnosed with Charcot arthropathy in 2003. Compared with persons without obesity or peripheral neuropathy, those with obesity alone were approximately 59% more likely, those with neuropathy alone were 14 times more likely, and those with both obesity and neuropathy were 21 times more likely to develop Charcot arthropathy. Ages 55 to 64 years, diabetes duration 6 years or more, hemoglobin-A1c 7% or more, renal failure, arthritis, and deficiency anemia also were associated with an increased incidence of Charcot arthropathy.

CONCLUSION

Obesity is significantly associated with an increased incidence of Charcot arthropathy independently of other risk factors. When obesity is combined with neuropathy, the Charcot arthropathy incidence rate increases multiplicatively. Prevention and detection of Charcot arthropathy should take the interaction between obesity and neuropathy into consideration.

Clinical characteristics of patients with diabetic polyneuropathy: the role of clinical and electromyographic evaluation and the effect of the various types on the quality of life

OBJECTIVE

This study was performed to identify the relationship between the quality of life and polyneuropathy which is one of the complications of diabetes.

METHODS

Total 111 patients with diabetes mellitus were taken into the study as type 1 and type 2. Patients were accepted having polyneuropathy according to their electroneuromyography (ENMG) results. To evaluate the quality of life in the patients Short Form 36 (SF-36) and World Health Organization Quality of Life Questionnaire abbreviated version (WHOQOL-BREF) were used.

RESULTS

Clinical polyneuropathy was found in 46% of the patients, while polineuropathy was found in 63% of the patients with evaluation ENMG. The patients with polyneuropathy had poor quality of life according to SF-36 and WHOQOL-BREF (p < 0.001). The mean quality of life scores of patients who had sensoriomotor and mix polyneuropathy, were lower than sensory type and axonal polyneuropathy.

CONCLUSION

Diabetic polyneuropathy influences the quality of life in a negative way. The quality of life scores of patients who had polyneuropathy continuing with mixed pathogenesis and sensoriomotor type, become worse for this reason, even if the patients do not have any clinical polyneuropathy, this being evaluated with ENMG.