Background. Peripheral neuropathy is a common neurological complication in uremic patients, and quantitative sensory testing (QST) is effective for diagnosis of small fiber neuropathy. Malnutrition and arterial stiffness are prevalent in patients undergoing hemodialysis (HD). The associations of small fiber neuropathy with nutritional status and arterial stiffness remain uncertain in maintenance HD patients. Methods. A total of 152 HD patients were included. Geriatric nutritional risk index (GNRI), an indicator of nutritional status, was calculated by serum albumin and actual and ideal body weight. Arterial stiffness was defined as brachial-ankle pulse wave velocity . Small fiber neuropathy was assessed by an abnormal QST threshold of cold and warm sensation in patients’ hands or feet. Multivariate forward logistic regression analysis was performed to examine the associations among abnormal QST threshold, GNRI, and arterial stiffness. Results. baPWV and prevalence of abnormal QST threshold were significantly higher in diabetic patients. Multivariate logistic analyses revealed that older age (OR, 1.081; 95% CI, 1.026–1.139, ) and male gender (OR, 4.450; 95% CI, 1.250–15.836, ) were associated with abnormal warm threshold of hands. Furthermore, diabetes (OR, 3.966; 95% CI, 1.351–11.819, ) and lower GNRI (per 1 unit increase, OR, 0.935, 95% CI, 0.887–0.985, ) were associated with abnormal cold threshold of feet. Arterial stiffness (OR, 5.479, 95% CI, 1.132–22.870, ) and higher calcium-phosphorus product (OR, 1.071, 95% CI, 1.013–1.132, ) were associated with abnormal warm threshold of feet. Conclusions. Lower GNRI and arterial stiffness were significantly associated with small fiber neuropathy in patients undergoing HD. Malnutrition risk and vascular factors might play important roles in small fiber neuropathy among patients undergoing HD.

中文翻译：

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血液透析中小纤维神经病变与老年营养风险指数和动脉僵硬度的关系。

背景。周围神经病变是尿毒症患者常见的神经系统并发症，定量感觉测试（QST）对小纤维神经病变的诊断有效。营养不良和动脉僵硬在接受血液透析 (HD) 的患者中很普遍。在维持性 HD 患者中，小纤维神经病变与营养状况和动脉僵硬度的关系仍不确定。方法。共纳入 152 名 HD 患者。老年营养风险指数（GNRI）是营养状况的指标，由血清白蛋白和实际体重和理想体重计算得出。动脉僵硬度定义为臂踝脉搏波速度. 小纤维神经病变通过患者手或脚冷暖感觉的异常 QST 阈值进行评估。进行多变量正向逻辑回归分析以检查异常 QST 阈值、GNRI 和动脉僵硬度之间的关联。结果。糖尿病患者的 baPWV 和异常 QST 阈值的发生率显着升高。多变量逻辑分析显示，年龄较大（OR，1.081；95% CI，1.026–1.139，)和男性 (OR, 4.450; 95% CI, 1.250–15.836,)与异常的手温阈值有关。此外，糖尿病（OR，3.966；95% CI，1.351–11.819，)和较低的 GNRI (每增加 1 个单位，OR, 0.935, 95% CI, 0.887–0.985,)与脚的异常冷阈有关。动脉僵硬度 (OR, 5.479, 95% CI, 1.132–22.870,)和更高的钙磷产品 (OR, 1.071, 95% CI, 1.013–1.132,)与异常的脚温阈值有关。结论。较低的 GNRI 和动脉僵硬度与 HD 患者的小纤维神经病变显着相关。营养不良风险和血管因素可能在 HD 患者的小纤维神经病变中起重要作用。