{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:15:33Z","timestamp":1789035333553,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accelerated neuropathy is a rare syndrome of rapidly worsening peripheral neuropathy, typically described in end\u2010stage kidney disease (ESKD) patients undergoing dialysis. In our center, we encountered a surge in the occurrence of accelerated neuropathy among ESKD patients undergoing hemodialysis, which prompted systematic research.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this case\u2013control study, we present the clinical features, electrophysiologic findings, and outcome of a series of patients who developed accelerated neuropathy after commencing hemodialysis for ESKD. Those who initiated hemodialysis and did not develop accelerated neuropathy were included as controls. We used logistic regression to identify predictors of accelerated neuropathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 436 ESKD patients who initiated hemodialysis over 4\u2009years, 17 were diagnosed with accelerated neuropathy. The median\u2010time (interquartile range) from hemodialysis initiation to presentation with accelerated neuropathy was 3\u2009weeks (2\u20136). It typically presented as acute onset of unsteadiness of gait necessitating assistance for ambulation. Electrophysiology revealed length\u2010dependent symmetric sensorimotor axonal neuropathy. Diabetes mellitus (odds ratio [OR] 4.1, 95% CI 1.2\u201313.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), pre\u2010existing peripheral neuropathy (OR 9.25, 95% CI 2.79\u201330.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and serum alkaline phosphatase (OR 1.2 for every 10\u2009U increase, 95% CI 1.00\u20131.52, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) significantly predicted accelerated neuropathy. With continued dialysis and supportive care, neurologic status improved, total\u2010neuropathy score (summary score of peripheral nerve dysfunction incorporating clinical and electrophysiological parameters) declined from 26.5 to 18.4 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and most regained unassisted ambulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study presents the largest series of patients with accelerated neuropathy and has identified predictors. However, in view of the unusually high incidence of accelerated neuropathy we speculate that other unidentified factor(s) could be underlying its pathogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.13143","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:14:22Z","timestamp":1709784862000},"page":"188-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Accelerated neuropathy among chronic kidney disease patients undergoing hemodialysis: <scp>Analysis<\/scp> of an institutional cluster"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-165X","authenticated-orcid":false,"given":"Subrahmanian","family":"Sathiavageesan","sequence":"first","affiliation":[{"name":"Department of Nephrology Sundaram Hospital  Trichy India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subramani","family":"Murugan","sequence":"additional","affiliation":[{"name":"Department of Medicine Government KAPV Medical College  Trichy India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20713"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540050078020"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2011.559677"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"5","article-title":"Classification of alcohol use disorders","volume":"27","author":"Hasin D","year":"2003","journal-title":"Alcohol Res Health"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nic.2013.03.023"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.02.120"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.8.1660"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.01.017"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2013.828261"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2013.06.022"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00670117"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048004016677687"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq144"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2019.1555468"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229722"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.09.009"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1985.tb08866.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.17151120"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199701)20:1<59::AID-MUS8>3.0.CO;2-G"},{"key":"e_1_2_10_21_1","first-page":"413","article-title":"Subacute motor neuropathy developing after the induction of hemodialysis","volume":"32","author":"Kuwabara S","year":"2005","journal-title":"Muscle Nerve"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S44660"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.13143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:01:48Z","timestamp":1715565708000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.13143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,6]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/hdi.13143"],"URL":"https:\/\/doi.org\/10.1111\/hdi.13143","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"value":"1492-7535","type":"print"},{"value":"1542-4758","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,6]]},"assertion":[{"value":"2023-07-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}