KEY TAKEAWAYS
- The study aimed to investigate the effectiveness of COMPASS 31 in detecting various domains of AN in dialysis patients.
- Researchers noticed that COMPASS 31 effectively identifies AN in dialysis patients and correlates with diabetes duration.
Autonomic neuropathy (AN) is prevalent among patients with diabetes and advanced renal disease, yet traditional diagnostic methods lack the capability to detect the various domains of AN effectively. The COMPASS 31, a novel self-assessment tool, has demonstrated reliable performance in assessing not only cardiac AN but also different sub-domains of AN.
Catharina Verena Schramm and the team aimed to assess the effectiveness of COMPASS 31 in evaluating AN across its various domains in dialysis patients and its correlation with the duration of diabetes.
They performed an inclusive analysis involving 183 patients, with 119 undergoing permanent dialysis therapy (HD) and 64 serving as controls (eGFR > 60 ml/min). Using COMPASS 31, various symptoms of AN were assessed, including orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor changes. These symptoms were quantified and converted into AN scores to evaluate the prevalence and severity of AN among the participants.
AN was more pronounced in dialysis patients than in controls (AN-score 27.5 vs. 10.0; P < 0.01). These differences were present also in every sub-domain of AN (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor changes; P < 0.05 for all sub-domains).
In diabetic patients, there was a strong correlation between symptoms of AN and diabetes duration (correlation coefficient r = 0.45, P < 0.001). Current glycemic control (HbA1c), body mass index (BMI), sex, and height did not influence AN when comparing dialysis patients and controls. C-reactive protein (CRP) showed a positive linear correlation with AN-scores (correlation coefficient r = 0.21; P < 0.05).
The study concluded that symptoms of AN are more pronounced in dialysis patients across all domains of neuropathic changes. The duration of diabetes was positively correlated with the development of AN.
Future longitudinal studies may help identify the high cardiovascular and mortality risk in dialysis patients by utilizing the easy-to-use COMPASS 31, which offers a non-invasive and efficient method for diagnosing AN.
The study received open-access funding from Projekt DEAL.
Source: https://pubmed.ncbi.nlm.nih.gov/39118055/
Schramm CV, Schramm MC, Trautner M, et al. (2024). “Autonomic neuropathy in dialysis patients – investigations with a new symptom score (COMPASS 31).” BMC Nephrol. 2024;25(1):256. Published 2024 Aug 8. doi:10.1186/s12882-024-03691-y
