Effect of tremors on handwriting in patients at end stage renal diseases and on chronic hemodialysis

For document experts, determining the reasons behind tremors in handwritten strokes is never easy. When they faced shaky line writings, they conclude that the document is a fake, even if this may not always be the truth. Some genuine writers who are elderly, illiterate, or experiencing other health problems may also have tremors in their handwriting. Patients with chronic hemodialysis develop metabolic abnormalities, myopathies, and cognitive impairment with a subsequent effect on the quality of the handwriting. To assess the effect renal impairment and chronic hemodialysis on handwriting. This study included 50 patients on chronic hemodialysis for end-stage renal disease. Their handwritings were evaluated in comparison to earlier records from the hospital and prior paperwork. To determine whether there were any tremors in the up, down, or both strokes, their handwriting was analyzed using a hand lens. 82% of the patients having down strokes tremors compared to their prior writings. Appearance of tremors in individual handwriting is a good indicator of development of motor dysfunction.