Neurological sequelae of end stage renal disease (ESRD)

Nissenson, Allen R.; Levin, Murray L.; Klawans, Harold L.; Nausieda, Paul L.

doi:10.1016/0021-9681(77)90001-7

Cited by 17 publications

(5 citation statements)

References 162 publications

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“…It has been reported that subtle neurological dis turbances, as well as impaired cognitive functions, are clearly detectable in uremic patients and may persist also during the regular dialysis treatment [1,2]. Impairment of vision, audition, sustained attention and alertness, selective attention, mental manipulation of symbols and time per ception were reported in these patients [3][4][5], Uremic pa tients frequently complain about loss of appetite, dull taste of food, and often report a persistent unpleasant taste sensation.…”

Section: Introductionmentioning

confidence: 99%

Malrecognition of Taste in Uremia

Peresecenschi

Aviram

et al. 1980

Nephron

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Impaired cognitive functions were reported in uremia. The purpose of this study was to quantify the functional state of taste in various stages of chronic renal failure. Taste sensitivity was assessed by asking the subjects to identify test solutions of sucrose (‘sweet’), NaCl (‘salty’), citric acid (‘sour’), quinine (‘bitter’) and water presented randomly in five concentrations. The number of recognition errors was statistically analyzed as a measure of taste acuity. Four groups of subjects were examined: 20 nondialyzed uremic patients, 23 patients on regular hemodialysis, 20 patients suffering from chronic diseases with normal renal functions and 22 healthy volunteers. Nondialyzed and dialyzed uremic patients younger than 55 years had a significant impairment of recognition in all taste modalities when compared to both control groups. This was less obvious in patients older than 55 years. No differences in taste recognition were found between dialyzed and nondialyzed uremics of all ages. In the younger age group, however, there was improvement in the recognition of ‘sour’ and ‘bitter’ when tested before and immediately after the dialysis session. As zinc deficiency was excluded in all of the uremic patients we conclude that the impaired taste perception is another subtle facet of the uremic neuropathy.

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Section: Introductionmentioning

confidence: 99%

Malrecognition of Taste in Uremia

Peresecenschi

Aviram

et al. 1980

Nephron

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“…Zusätzlich erfolgten neurologisch-psychiatrische und internistische Kontrollen. Dabei sind beim Dialysepatienten nicht nur die Veränderungen durch die Dialyse selbst von Bedeutung, sondern auch die zuvor erfolgten Schädigungen im Rahmen der chronischen renalen InsuffIzienz mit allen Sekundärfolgen (Nissenson et al, 1977). Aus der Vielfalt dieser Faktoren sind jedoch in unserem Krankengut der Blutdruck, das Patientenalter und vor allem die Dialysedauer (und damit im weite• ren auch in gewissem Umfang die Dialyse selbst) als unwesentlich für das Entstehen der Demenz anzusehen.…”

Section: Krankengut Und Methodikunclassified

“…Auf der anderen Seite sind es organisch determinierte Veränderungen am zentralen und peripheren Nervensystem, bei denen Hypertonie, Hypotonie, Anämie, Herzin-suffIzienz, verstärkte Arteriosklerose durch Hyperparathyreoidismus und Hyperlipidämie, Elektrolytstörungen, osmotische Verschiebungen während der Dialyse, Urämie mit Transmittermangel bzw. direkt toxischer Wirkung sowie Intoxikationen durch Metalle zusammenwirken (Nissenson et al, 1977, Alfrey, 1978. Diese einzelnen Faktoren können sowohl akut und isoliert als auch chronisch und in Kombination von Bedeutung sein.…”

Section: Zusammenfassungunclassified

Die Bedeutung von Aluminium bei der Dialyseenzephalopathie

Ladurner¹,

Holzer²,

Wawschinek³

et al. 1981

Fortschr Neurol Psychiatr

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64 patient on chronic haemodialysis were investigated. The duration of the dialysis was 44 months; the mean age of patients was 41 years. In 6 patients a diagnosis of Dementia was made in addition to apraxia, dysarthria and anarthria. 5 of the patients died. All the demented patients showed an abnormal EEG and 4 had atrophy in the computertomogram. The plasma aluminium levels were significantly raised (409 microgram/l) in the demented group as compared to the non-demented dialysis patients (189 microgram/l).

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“…have also been excluded as the cause of the dementia by clinical investigations in cluding computer tomography and regional cerebral blood flow [Ilolzer et al, 1981;Ladurner et al, 1981]. Neuropathy is often found in the end stages of renal disease [Nissenson et al, 1977], EMG and nerve conduc tion velocity are sensitive parameters for its detection. Vitamin B deficiency, toxic prod ucts and changes in the vasa nervorum have been discussed as causes of the neuropathy both in the end stages of renal disease and in patients on dialysis [Elkbom, 1944;Dyck et al, 1971;Buselmeier et al, 1972;Nielsen, 1973], Considering the effect of aluminium on the central nervous system, the question arises whether aluminium also has any effect on the peripheral nerves.…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological Findings and Serum Aluminium in Dialysis Encephalopathy

Ladurner¹,

Wawschinek²,

Pogglitsch³

et al. 1982

Eur Neurol

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64 patients on hemodialysis were investigated. The mean duration of dialysis was 43 months. In all the patients, serum aluminium levels, systolic blood pressure (averaged over a period of 6 weeks) and the EEG were investigated. Psychological testing to assess the level of intelligence (IQ) was also performed. The serum aluminium levels have been assayed by flameless atomic absorption (Perkin-Elmer atomic absorption spectrophotometer model 420). In 6 patients, the diagnosis of dementia was made on the basis of psychological testing and clinical observations. The demented patients showed significantly (p < 0.01) higher aluminium levels (mean 409 µg/1, SD 235) than the 58 non-demented patients (mean 189 µg/l, SD 152), whereas the age of the patients, duration of dialysis and blood pressure were the same in both groups. The EEG was abnormal in all 6 demented patients. Only in 23 of the 58 non-demented patients was the EEG pathological (p < 0.05). A significant correlation was found between serum aluminium levels and the EEG data with regard to bilateral slow waves, focal slow waves and epileptic potentials (p < 0.05). The EEG, age of the patients, duration of dialysis and blood pressure showed no correlation. Electromyography, nerve conduction velocity and latency showed no correlation with aluminium levels or dementia. It can be concluded from our findings that in dialyzed patients there is a correlation between serum aluminium levels and the appearance of dementia and EEG changes.

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Neurological sequelae of end stage renal disease (ESRD)

Cited by 17 publications

References 162 publications

Malrecognition of Taste in Uremia

Malrecognition of Taste in Uremia

Die Bedeutung von Aluminium bei der Dialyseenzephalopathie

Neurophysiological Findings and Serum Aluminium in Dialysis Encephalopathy

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