Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program

Abstract

Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.

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“…As these two chronic diseases are very common and have high rates of sudden death, we evaluated what would be the scenario if the same person had both conditions 13 . In order to do it, we investigated the relationship of seizure frequencies in people with end-stage renal disease (ESRD) under regular dialysis program 14 . Seven out of 189 ESRD cases had convulsive seizure during the dialytic program 14 , therefore it was evident that despite the belief that seizures were rare among ESRD individuals receiving dialysis, this was not the case.…”

“…In order to do it, we investigated the relationship of seizure frequencies in people with end-stage renal disease (ESRD) under regular dialysis program 14 . Seven out of 189 ESRD cases had convulsive seizure during the dialytic program 14 , therefore it was evident that despite the belief that seizures were rare among ESRD individuals receiving dialysis, this was not the case. Indeed, this suggested that a clinical convergence of neurologists and nephrologists in the context would be helpful [13][14][15] .…”

“…Seven out of 189 ESRD cases had convulsive seizure during the dialytic program 14 , therefore it was evident that despite the belief that seizures were rare among ESRD individuals receiving dialysis, this was not the case. Indeed, this suggested that a clinical convergence of neurologists and nephrologists in the context would be helpful [13][14][15] . We also looked at a possible link between epilepsy, cardiovascular abnormalities, and SUDEP among ESRD cases undergoing regular hemodialysis 13,16 .…”

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“…From this perspective and mainly due lack of data in the world, our research group decided to investigate the possible relationship between seizure frequencies in patients with end-stage renal disease (ESRD) under regular dialysis program 4 . Briefly, from 189 ESRD patients, 7 had suffered some type of convulsive seizure during dialytic program 4 . At that time, we concluded that despite the occurrence of seizures is considered rare among ESRD individuals receiving dialysis, it should be apparent that a true convergence of clinical nephrology and neurology should always be part of this scenario 4 .…”

“…Thus, as these two chronic diseases are very common in the world and also a global public health problem, a new line of translational research would have great value in helping neurologists and nephrologists to investigate what would be the best strategy to be drawn if these two chronic diseases involve the same individual. From this perspective and mainly due lack of data in the world, our research group decided to investigate the possible relationship between seizure frequencies in patients with end-stage renal disease (ESRD) under regular dialysis program 4 . Briefly, from 189 ESRD patients, 7 had suffered some type of convulsive seizure during dialytic program 4 .…”