Neurologic disorders in renal failure

Tyler, H. Richard

doi:10.1016/0002-9343(68)90255-6

Cited by 238 publications

(70 citation statements)

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“…Calculating CBP from this equation in the dialyzed patients using a hematAs focal or diffuse brain tissue damage is invari ably followed by a reduction in CBF, there are rea sons to expect a CBF decrease in patients on long term hemodialytic treatment. First, the renal dis ease itself may cause uremic encephalopathy (Olsen, 1961;Tyler, 1968), although today most pa tients will receive hemodialysis early in the course of their disease to prevent long-standing severe ure mia. Second, a severe progressive neurological syn drome called dialysis dementia evolves in a number of patients regularly treated with hemodialysis.…”

mentioning

confidence: 99%

Increased Cerebral Blood Flow in Anemic Patients on Long-Term Hemodialytic Treatment

Vorstrup

Lass

Waldemar

et al. 1992

J Cereb Blood Flow Metab

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Summary: CBP was measured in 15 patients on chronic hemodialytic treatment. CBP was measured with xenon-133 inhalation using single photon emission tomography. In addition, computerized tomography (CT) and a neuro logical examination were done prior to hemodialysis. Mean CBP was 66.2 ± 17.3 (SD) ml 100 g-I min-I, which was significantly higher (t-test, p < 0.05) than for an age-matched control group (54.7 ± 10.2 ml 100 g-I min -I). However, the hematocrit for the patients was considerably lower, 0.30 ± 0.07, as compared to 0.43 ± 0.03 in the controls. A significant negative correlation was observed between CBP and the hematocrit (y = -1.79x + 120.7, r = -0.71, p < 0.01). Calculating CBP from this equation in the dialyzed patients using a hematAs focal or diffuse brain tissue damage is invari ably followed by a reduction in CBF, there are rea sons to expect a CBF decrease in patients on long term hemodialytic treatment. First, the renal dis ease itself may cause uremic encephalopathy (Olsen, 1961;Tyler, 1968), although today most pa tients will receive hemodialysis early in the course of their disease to prevent long-standing severe ure mia. Second, a severe progressive neurological syn drome called dialysis dementia evolves in a number of patients regularly treated with hemodialysis. The etiology of this syndrome was originally found to relate to a high aluminum content in the dialysate (Alfrey et aI., 1976;Alfrey, 1987). Lately, it has Received November 22, 1991; final revision received March 18, 1992; accepted March 18, 1992. Address correspondence and reprint requests to Dr. Sissel Vorstrup, Department of Neurology, Rigshospitalet, 9, Blegdamsvej, 2100 Copenhagen, Denmark.Abbreviations used: CT, computed tomography; CM, can thomeatal (plane); Hct, hematocrit; PET, positron emission to mography. 745ocrit of 0.43 yielded a mean CBP value of 43.7 mlloo g-I min -I, i.e., 20% below the expected. Two patients showed a focal CBP decrease. CT showed central or cor tical atrophy in five patients, and two had small hypo dense lesions. The neurological examination revealed slight to moderate dementia in seven cases. Although mean CBP was found to be increased by 21% as com pared to the control group, an even higher CBP level would have been expected to outweigh the decreased ox ygen carrying capacity of the blood. The findings suggest a lowered metabolic demand of the brain tissue, probably due to subtle brain damage. Key Words: Anemia-CBP Hemodialysis.been suggested that even the moderately increased aluminum levels in the blood, often seen in these patients because of a high daily intake of aluminum containing phosphate-binding gels, may cause de mentia (Altmann et aI., 1989). Third, hypotensive episodes, arterial hypoxemia, and fluctuations in electrolytes and cerebral water content may occur during hemodialysis and cause subtle subclinical brain tissue damage (Savazzi et aI., 1985). Finally, the underlying process for the renal disease could cause brain damage and thereby decrease CBF. We therefore studied the in...

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mentioning

confidence: 99%

Increased Cerebral Blood Flow in Anemic Patients on Long-Term Hemodialytic Treatment

Vorstrup

Lass

Waldemar

et al. 1992

J Cereb Blood Flow Metab

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“…place within hours to a few days 26 , and it was probably described by Job (result c). Anxiety, irritability, and psychosis are also frequent in uremic patients, and Job presented some of these symptoms (result f).…”

Section: Discussionmentioning

confidence: 67%

“…Although depression is frequent in uremia, the probable visual hallucinations and loss of sight (b and c in results) suggest an organic cause of psychiatric disturbances 26 . The so called "uremic amaurosis" is an acute loss of vision in uremic patients.…”

Section: Discussionmentioning

confidence: 92%

Solving the conundrum of Job: a probable biblical description of chronic renal failure with neurological symptoms

Resende

Kirchner

Resende

2009

Arq. Neuro-Psiquiatr.

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-The disease described in the Bible's Book of Job is controversial and had been of interest of theologists, psychiatrists, and dermatologists for many years. We describe several signs and symptoms compatible with chronic renal failure with neurological alterations.Key Words: bible, Job, chronic renal failure. Resolvendo o enigma de Jó: uma provável descrição bíblica de insuficiência renal crônica com sintomas neurológicosResumo -A doença descrita no livro bíblico de Jó é controversa, e tem interessado a teólogos, psiquiatras e dermatologistas, há tempos. Neste trabalho os autores apontam para evidências do diagnóstico de insuficiência renal crônica com alterações neurológicas.PAlAvrAs-chAve: bíblia, Jó, insuficiência renal crônica.

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“…The uremic symptoms include disturbed functions of nervous systems and muscles (TYLER, 1968;RASKIN and FISHMAN, 1976a, b). Physiological examinations of uremic patients frequently reveal an electroencephalographic abnormality (TYLER, 1968), a depressed sensory or motor nerve conduction velocity (NIELSEN, 1974;TACKMANN et al, 1974;BOLTON, 1976;LANG and FORSSTROM, 1977;HANSEN and BALLANTYNE, 1978) and a lower resting membrane potential of muscle fibers (COTTON et al, 1979).…”

mentioning

confidence: 99%

“…Physiological examinations of uremic patients frequently reveal an electroencephalographic abnormality (TYLER, 1968), a depressed sensory or motor nerve conduction velocity (NIELSEN, 1974;TACKMANN et al, 1974;BOLTON, 1976;LANG and FORSSTROM, 1977;HANSEN and BALLANTYNE, 1978) and a lower resting membrane potential of muscle fibers (COTTON et al, 1979). In the search for uremic toxins causing these alterations, MAN (1979) has recently shown in a study in vitro with frog sural nerves that plasma ultrafiltrate of uremic patients inhibits the amplitude of the action potential.…”

mentioning

confidence: 99%

Depression of nerve-mediated smooth muscle contractions in vitro by plasma of an anephric rabbit and uremic patients.

Matsumoto¹,

Yamasaki²,

Yonemura

et al. 1981

Jpn.J.Physiol

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Neurologic disorders in renal failure

Cited by 238 publications

References 50 publications

Increased Cerebral Blood Flow in Anemic Patients on Long-Term Hemodialytic Treatment

Increased Cerebral Blood Flow in Anemic Patients on Long-Term Hemodialytic Treatment

Solving the conundrum of Job: a probable biblical description of chronic renal failure with neurological symptoms

Depression of nerve-mediated smooth muscle contractions in vitro by plasma of an anephric rabbit and uremic patients.

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