Polyneuropathy in kidney transplant recipients
Polyneuropathy in kidney transplant recipients
Advances in kidney transplantation have enabled patients to live longer with a well-functioning donor kidney. As a result, increasing attention is being paid to long-term health problems that may develop. One such problem is polyneuropathy, a condition caused by damage to peripheral nerves that can lead to pain, tingling, numbness, muscle weakness, and difficulties with walking and balance.
In this thesis, Svea Nolte investigated how polyneuropathy can be better recognised and diagnosed in kidney transplant recipients. We developed new reference values for measuring vibration sensation and evaluated clinical screening tools that can be used to detect polyneuropathy in a reliable and practical way.
Our research showed that polyneuropathy is common after kidney transplantation but often remains unrecognised. More than half of the patients studied had polyneuropathy affecting the large nerve fibres, while only a small proportion had previously been diagnosed. Polyneuropathy was more common in older patients, men, and patients with diabetes or higher urea levels.
We also investigated tacrolimus, an important medication used to prevent rejection of the transplanted kidney. Our findings suggest that measuring tacrolimus concentrations in plasma may better reflect side effects and reduced quality of life than the currently used measurements in whole blood.
Finally, more severe symptoms of polyneuropathy were related to poorer physical quality of life, and polyneuropathy was associated with an increased risk of death. Better recognition and diagnosis of polyneuropathy may therefore contribute to more personalised care and potentially improve long-term outcomes after kidney transplantation.