The relationship between the presence of neuropathic pain and quality of life, oxidative stress, and inflammatory parameters in hemodialysis patients

Abstract

Background & Objective: Neuropathic pain (NP) is common in hemodialysis patients and severely reduces their quality of life. Diabetes, inflammation, and oxidative stress are factors implicated in the development of NP, regardless of dialysis status. This study explored links between neuropathic pain, oxidative stress, inflammation, and quality of life in hemodialysis patients.

Methods: The study prospectively included 113 HD patients, grouped by Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) score (NP ≥12, control: <12).The groups were compared in terms of oxidative stress (native thiol, total thiol, disulfide, and Ischemia-Modified Albumin (IMA) levels) and inflammatory parameters (Systemic Immune-inflammation Index (SII)). The groups were also compared in terms of the Charlson Comorbidity Index (CCI), quality of life (SF-36), and disease perception (B-IPQ).

Results: The native thiol/total thiol ratio was significantly higher in the NP group; however, disulfide levels, disulfide/native thiol, and disulfide/total thiol ratios were higher in the control group (p<0.05). There was no difference between the groups in terms of other parameters. NP presence was associated with a significant decrease in quality of life in all SF-36 subscales (p<0.05). Thiol/disulfide parameters were identified as independent predictors.

Conclusion: The presence of NP in hemodialysis patients is associated with impaired thiol/disulfide homeostasis, independent of diabetes and inflammation. Oxidative stress may play a dominant role in NP pathogenesis and that thiol/disulfide balance is a more sensitive biomarker compared to IMA.