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

Nolte, S.

Clinical Assessment ▼

Patient Symptoms: Ask about symptoms in the feet. Absent (green) = no symptoms. Mild (yellow) = symptom present, not interference with sense of well-being or ADL. Moderate (orange) = symptom present, interference with well-being but not with ADL. Severe (red) = symptom causes interference with well-being and ADL.

Numbness in feet

Absent

Mild

Moderate

Severe (ADL)

Tingling in feet

Absent

Mild

Moderate

Severe (ADL)

Clinical Tests: Test bilaterally. Score as abnormal only if both sides are affected. Options are color-coded: green (normal), yellow (mild), orange (moderate), red (severe/absent).

Pinprick Test (Nociception)

Normal

↓ Both toes

↓ To dorsum

↓ Above ankle

Vibration Perception (Biothesiometer)

Normal

↓ Both toes

↓ To dorsum

↓ To malleoli

0

KTNS-Basic Score

Score <3 — Low Risk No indication for neurologist referral at this time. Continue routine monitoring.

Score Breakdown ▼

Component	Score
Numbness	0
Tingling	0
Pinprick Test	0
Vibration Perception	0
Achilles Reflex	0
Patellar Reflex	0
Total Score	0

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Clinical Information & Disclaimer ▼

Purpose: The KTNS (Kidney Transplant Neuropathy Score) is a validated screening tool designed to support clinical decision-making by physicians. It helps identify kidney transplant recipients who may benefit from further neurological diagnostic evaluation.

Intended Use: This tool is validated for kidney transplant recipients ≥12 months post-transplantation during routine outpatient follow-up. Definitive diagnosis of polyneuropathy requires additional testing such as nerve conduction studies (NCS) and/or quantitative sensory testing (QST).

Validation: KTNS was validated in a Dutch cohort of 160 kidney transplant recipients using an expert panel of three neurologists as reference standard. KTNS-Basic: AUC 0.85 (95% CI: 0.79-0.90), sensitivity 68%, specificity 87%. KTNS-Advanced: AUC 0.90 (95% CI: 0.85-0.94), sensitivity 81%, specificity 81%. Cutoff for both models: ≥3 points.

Clinical Responsibility: The treating physician remains responsible for all clinical decisions. This tool does not generate diagnoses and does not replace clinical examination or professional medical judgment.

Reference: Nolte et al. (2025). Polyneuropathy in Kidney Transplant Recipients: Accuracy of a New Clinical Diagnostic Scoring System. J Peripher Nerv Syst, 30, e70058.

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