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Verywell Health

Verywell Health

Understanding Uremic Neuropathy

Understanding Uremic Neuropathy

Read about the causes, symptoms, and management of chronic kidney disease-related neuropathy.


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Neuropathy, a condition involving nerve damage, often manifests as tingling, numbness, and pain in the peripheral nerves–all the nerves that lie outside your brain and spinal cord. Among those with kidney disease, uremic neuropathy—a form specific to advanced or end-stage kidney disease—is particularly common. Learn why uremic neuropathy develops, what symptoms you may experience, and the treatment options available.*

Why Neuropathy Occurs in Kidney Disease

Patients with advanced kidney disease, especially those undergoing dialysis, are at a significantly higher risk for uremic neuropathy. The underlying causes of this heightened risk remain unclear, but several contributing factors have been identified, including:

  • Nerve degeneration associated with kidney failure,
  • Imbalances such as a deficiency in thiamine (vitamin B1) or an excess of zinc, and
  • Diabetes (diabetic nephropathy is closely linked to neuropathy). 

Even dialysis can exacerbate nerve issues; high pressure or excess fluid near the dialysis access site can compress nearby nerves, while elevated phosphorus levels may cause calcium-phosphate deposits that impair nerve function. 

Beyond dialysis, the primary causes of kidney disease, like diabetes, may also contribute, as diabetic nephropathy is closely linked to neuropathy.

Symptoms and Impact of Neuropathy

Neuropathy symptoms vary depending on the affected nerves. Many patients report sensations of tingling, numbness, or a pricking feeling in the hands or feet, often described as “burning” or “pins and needles.” These symptoms can severely affect daily life, and as the condition progresses, they may lead to more debilitating issues.

Advanced neuropathy can result in muscle weakness and muscle atrophy, where affected muscles shrink due to prolonged nerve damage. These complications can significantly impair mobility and quality of life, underscoring the importance of early diagnosis and intervention.

Diagnosing and Treating Uremic Neuropathy

Diagnosing neuropathy often begins with a kidney specialist evaluating symptoms. If confirmation is needed, a referral to a neurologist may follow. Diagnostic tools such as nerve conduction studies and electromyography (EMG) help pinpoint the issue. Blood tests may also rule out other causes.

Treatment primarily targets the root cause. A kidney transplant is the most effective solution for uremic neuropathy, but for many, adjustments to dialysis or supplementation to address nutrient deficiencies are necessary. Symptom relief can often be found through medications such as:

  • Antidepressants, 
  • Anti-seizure drugs, and
  • Topical agents. 

Complementary therapies like physical therapy, acupuncture, or transcutaneous electrical nerve stimulation (TENS) can also support recovery and pain management.

Neuropathy in kidney disease patients is a complex condition with diverse causes, symptoms, and treatments. Understanding the interplay of factors such as dialysis, nutrient imbalances, and overlapping conditions like diabetes is crucial. 

*Chauhan, V. (2024, April 3). Neuropathy in Kidney Disease. Verywell Health. https://www.verywellhealth.com/neuropathy-in-patients-with-kidney-disease-4019578 

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