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Objective <p>This study aimed to investigate the blood urea threshold level that triggers myoclonic jerks in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) and evaluated the mediating role of the length of chronic kidney disease (CKD) in this neurological complication.</p> Methods <p>A cross-sectional study was conducted on ESRD patients undergoing hemodialysis at Evercare Hospital in Dhaka, Bangladesh, from April-July 2024. The presence of myoclonus was documented before and after hemodialysis, along with blood urea levels. Unadjusted and adjusted multivariate associations with pre-HD myoclonus were estimated using modified Poisson regression with robust standard errors to obtain crude and adjusted prevalence ratios (cPRs and aPRs, respectively).</p> Results <p>Among the 101 participants, pre-hemodialysis myoclonic jerks were present in 36 (35.64%). Diabetes and hypertension were reported by 75.25% and 90.10%, respectively. Patients with each additional year since CKD diagnosis showed a 27% higher prevalence of pre-hemodialysis myoclonus (aPR 1.27; 95% CI 1.18–1.48; <i>p</i> = 0.001); whereas, a longer interval from CKD diagnosis to first hemodialysis was associated with a 20% lower prevalence (aPR 0.80; 95% CI 0.69–0.93; <i>p</i> = 0.004). Although aPRs of pre-HD myoclonus were elevated across all higher pre-HD blood urea level categories, none of these increases reached statistical significance (<i>p</i> &gt; 0.05).</p> Conclusion <p>The prevalence of myoclonus rises with increasing pre-dialysis blood urea levels, yet no specific threshold could be identified. A longer duration of CKD is associated with a greater prevalence of myoclonus, while socio-demographic factors show no significant effect, highlighting the complex nature of this condition.</p> Trial registration <p>Not applicable.</p>

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Association of blood urea levels with myoclonic jerks in patients with end-stage renal disease on maintenance hemodialysis: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Shahpar Nahrir,
  • Saquiba Yesmine,
  • Sohail Moslem,
  • Md Al-Amin,
  • Kaniz Farjana Mumu,
  • Asma Jalal Panjery,
  • Md Atiqur Rahman Rafi,
  • Ummay Farwa Hoque,
  • A.F.M Noman,
  • Zannatul Ferdaus,
  • Rubiya Rahim,
  • Abrar Bin Ahsan,
  • Syed Asif Ahmed,
  • Tanveer Ahmed,
  • Azmain Ahanaf Adit,
  • Masum Kamal Khan,
  • Fahmida Begum,
  • Ebadur Rahman,
  • Ruksana Sharmin Swarna

摘要

Objective

This study aimed to investigate the blood urea threshold level that triggers myoclonic jerks in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) and evaluated the mediating role of the length of chronic kidney disease (CKD) in this neurological complication.

Methods

A cross-sectional study was conducted on ESRD patients undergoing hemodialysis at Evercare Hospital in Dhaka, Bangladesh, from April-July 2024. The presence of myoclonus was documented before and after hemodialysis, along with blood urea levels. Unadjusted and adjusted multivariate associations with pre-HD myoclonus were estimated using modified Poisson regression with robust standard errors to obtain crude and adjusted prevalence ratios (cPRs and aPRs, respectively).

Results

Among the 101 participants, pre-hemodialysis myoclonic jerks were present in 36 (35.64%). Diabetes and hypertension were reported by 75.25% and 90.10%, respectively. Patients with each additional year since CKD diagnosis showed a 27% higher prevalence of pre-hemodialysis myoclonus (aPR 1.27; 95% CI 1.18–1.48; p = 0.001); whereas, a longer interval from CKD diagnosis to first hemodialysis was associated with a 20% lower prevalence (aPR 0.80; 95% CI 0.69–0.93; p = 0.004). Although aPRs of pre-HD myoclonus were elevated across all higher pre-HD blood urea level categories, none of these increases reached statistical significance (p > 0.05).

Conclusion

The prevalence of myoclonus rises with increasing pre-dialysis blood urea levels, yet no specific threshold could be identified. A longer duration of CKD is associated with a greater prevalence of myoclonus, while socio-demographic factors show no significant effect, highlighting the complex nature of this condition.

Trial registration

Not applicable.