Polyneuropathy in Kidney Transplant Recipients: Accuracy of a New Clinical Diagnostic Scoring System

作者：Svea Nolte, Naser B.N. Shehab, Stefan P. Berger, Celina Oldag, Ilja M. Nolte, Bianca T. A. de Greef, Fiete Lange, Marco van Londen, Catharina G. Faber, Stephan J. L. Bakker, Pieter A. van Doorn, Harmen R. Moes, Gea Drost · 发表于：Journal of the Peripheral Nervous System · 年份：2025 · DOI：10.1111/jns.70058 · 被引用次数：2 · 研究领域：Renal Transplantation Outcomes and Treatments、Neurological Complications and Syndromes、Peripheral Neuropathies and Disorders

ABSTRACT Background and Aims Polyneuropathy is highly prevalent among kidney transplant recipients (KTR), underscoring the need for an accurate yet easy‐to‐perform diagnostic method to improve understanding and enable early identification of treatable cases. Methods This study included KTR at least 12 months post‐transplant at the University Medical Centre Groningen, the Netherlands. An expert panel assessed polyneuropathy through a structured neurological examination, quantitative sensory testing, and nerve conduction studies. The modified Toronto Clinical Neuropathy Score (mTCNS) was obtained from all participants. Logistic regression analyses with Firth penalization validated the mTCNS components. A new model, the Kidney Transplant Neuropathy Score (KTNS), was developed through stepwise elimination. Diagnostic performance was evaluated with bootstrapped metrics and ROC curve analyses. Results Among 160 KTR, 91 (57%) were diagnosed with polyneuropathy. All 10 mTCNS components were univariably associated with polyneuropathy; numbness (OR = 4.9 [1.8–18.0]), tingling (OR = 2.5 [1.2–5.9]), impaired nociception (OR = 1.5 [1.1–2.2]), and reduced vibration perception (OR = 1.5 [1.0–2.4]) remained independently associated in multivariable analysis. The mTCNS achieved an area under the curve (AUC) in ROC analysis of 0.83 [0.76–0.89]. Two KTNS were derived: the KTNS Basic , including history of numbness, tingling in the feet, and pinprick and vibration perception testing (AUC–ROC: 0....