Dialysis Encephalopathy: A Complication of Chronic Renal Failure Essay

Dialysis Encephalopathy: A Complication of Chronic Renal Failure The neurological problems that patients with chronic renal failure face are relatively new to the medical world. Although dialysis was technically feasible in the 1940’s, it has only been since 1960 that techniques and equipment have been developed to make long term dialysis available as a practical treatment for end stage renal failure. Further, it has only been since 1973 when Medicare legislation was amended to include patients with chronic renal failure; and the expansion of hospital dialysis services in addition to the emergence of private outpatient hemodialysis clinics, that hemodialysis has become available for the vast majority with end stage renal failure. By increasing services to many more patients, our experience with the problems associated with long term dialysis has grown. All body systems, including the central and peripheral nervous system, are affected by chronic renal failure and its treatment. We have developed an understanding of the long term effects of chronic hemodialysis and the physiological effects are still being studied, but some of the long term complications of chronic renal failure are still unknown. The neurological problems encountered in patients with chronic renal failure may be acute, such as dialysis disequilibrium syndrome. Dialysis disequilibrium syndrome is caused by abrupt changes in the osmotic pressure of the cerebrospinal fluid during dialysis. Chronic complications, such as uremic peripheral neuropathy and dialysis encephalopathy, also known as dialysis dementia, are also well documented. This paper will focus on one of those neurological complications of chronic renal failure namely dialysis encephalopathy. .. ...imental Aluminum Encephalopathy. Acta. Neuropathol., 50:19-24, 1980. 6. Asbury, A. K., McKhann, G., Mc Donald, D. Diseases of the Nervous System. Vol. 2, W. B. Saunders Company: Harcourt, Brace, Jovanovich ,Philadelphia, 1992. 7. Nissenson, A. R., Fine, R. N., Gentile, D. E. Dialysis in Chronic Renal Failure. Appleton-Century-Crofts, Norwalk, Connecticut, 1984. 8. Knochel, J. P. and Eknoyan, G. (Edt.) The Systemic Consequences of Renal Failure. Grune and Stratton, Inc. New York, 1984. 9. Geary, D. F. et. al. Encephalopathy in Children with Chronic Renal Failure. Journal of Pediatrics, 96: 41-44, 1980. 10.Rosati, G., De Bastiani, P., Gilli, P., and Paolino, E. Oral Aluminum and Neuropsychological Functioning. J. Neurol., 223: 251-7, 1980. 11.De Broe, M. E. and Coburn, J. W. Aluminum and Renal Failure. Kluwer Academic Publishers: Boston, 1990. Dialysis Encephalopathy: A Complication of Chronic Renal Failure Essay Dialysis Encephalopathy: A Complication of Chronic Renal Failure The neurological problems that patients with chronic renal failure face are relatively new to the medical world. Although dialysis was technically feasible in the 1940’s, it has only been since 1960 that techniques and equipment have been developed to make long term dialysis available as a practical treatment for end stage renal failure. Further, it has only been since 1973 when Medicare legislation was amended to include patients with chronic renal failure; and the expansion of hospital dialysis services in addition to the emergence of private outpatient hemodialysis clinics, that hemodialysis has become available for the vast majority with end stage renal failure. By increasing services to many more patients, our experience with the problems associated with long term dialysis has grown. All body systems, including the central and peripheral nervous system, are affected by chronic renal failure and its treatment. We have developed an understanding of the long term effects of chronic hemodialysis and the physiological effects are still being studied, but some of the long term complications of chronic renal failure are still unknown. The neurological problems encountered in patients with chronic renal failure may be acute, such as dialysis disequilibrium syndrome. Dialysis disequilibrium syndrome is caused by abrupt changes in the osmotic pressure of the cerebrospinal fluid during dialysis. Chronic complications, such as uremic peripheral neuropathy and dialysis encephalopathy, also known as dialysis dementia, are also well documented. This paper will focus on one of those neurological complications of chronic renal failure namely dialysis encephalopathy. .. ...imental Aluminum Encephalopathy. Acta. Neuropathol., 50:19-24, 1980. 6. Asbury, A. K., McKhann, G., Mc Donald, D. Diseases of the Nervous System. Vol. 2, W. B. Saunders Company: Harcourt, Brace, Jovanovich ,Philadelphia, 1992. 7. Nissenson, A. R., Fine, R. N., Gentile, D. E. Dialysis in Chronic Renal Failure. Appleton-Century-Crofts, Norwalk, Connecticut, 1984. 8. Knochel, J. P. and Eknoyan, G. (Edt.) The Systemic Consequences of Renal Failure. Grune and Stratton, Inc. New York, 1984. 9. Geary, D. F. et. al. Encephalopathy in Children with Chronic Renal Failure. Journal of Pediatrics, 96: 41-44, 1980. 10.Rosati, G., De Bastiani, P., Gilli, P., and Paolino, E. Oral Aluminum and Neuropsychological Functioning. J. Neurol., 223: 251-7, 1980. 11.De Broe, M. E. and Coburn, J. W. Aluminum and Renal Failure. Kluwer Academic Publishers: Boston, 1990.