Sudoscan and Cardiovascular outcomes in Hemodialysis

Sudoscan and Cardiovascular outcomes in Hemodialysis

Association of Electrochemical Skin Conductance by Sudoscan and Cardiovascular Outcomes
in Hemodialysis Patients

M Touzot et al. Kidney Int Rep (2022) 7, 2734–2736

Article reference:

We recently reported for the first time, the clinical pertinence of the Sudoscan to assess dysautonomia to predict intradialytic hypotension.

In a 24-month follow-up of the original cohort, we have now assessed the potential of Sudoscan
to predict cardiovascular events and overall mortality in a single cohort of Hemodialysis patients.

A total of 176 patients were included in the analysis. During the 24-month study, a first major adverse cardiovascular event (MACE) occurred in 41 patients that included 3 strokes, 4 acute myocardial infarctions, and 37 deaths.

Patients with MACE were older (73±12 vs. 62±14 years old, P < 0.001), with more diabetes mellitus (56 vs. 34%, P < 0.01), and had a higher rate of atrial fibrillation (34% vs. 14%, P < 0.01).
Mean predialysis foot ESC was significantly lower in patients with MACE, than those with no MACE (47±21 µS vs. 57±22 µS, P < 0.01). No difference in the mean predialysis hand ESC
(43±19 vs. 45±20 µS, P ¼ 0.34) were observed between these 2 groups.

HD patients with pathological foot ESC had a 3-fold increased risk of death
(hazard ratio [HR] = 3.74, 95% confidence interval [CI] 1.83– 7.63, P < 0.001). This association was confirmed with a multivariate Cox regression model. A pathological pre-HD foot ESC was also associated with an increased risk of death (HR = 2.92, 95% CI 1.36–6.26, P < 0.01). Similarly,
HD patients with pathological foot ESC had a 3- fold increased risk of MACE
(HR = 2.88, 95% CI 1.49–5.56, P < 0.01).

In conclusion, besides its capacity to predict intradialytic hypotension, the Sudoscan appears as a promising, simple, noninvasive, and quick test that can be used in routine to predict mortality and cardiac events in HD patients.


Cumulative incidence risk of death according to the presence of a pathological Foot ESC. The graph represents the cumulative incidence risk for death during the 24-month follow-up, according to the presence (red) or not (black) of a pathological foot ESC. HR, hazard ratio


Impeto Medical

Impeto Medical


SUDOSCAN is a quick and non-invasive test that provides an accurate evaluation of sweat gland function reflecting the status of the autonomic nervous system.

With quantitative and reproducible results, SUDOSCAN allows physicians to detect early and follow-up peripheral neuropathy to monitor disease progression and assess treatment efficacy for better patient management.

SUDOSCAN efficacy has been evaluated in the assessment of small fiber neuropathies in several diseases and compared to reference tests recommended in guidelines.

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