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.

-Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.KEy wOrDS: epilepsy, sudden death, heart, seizure, hemodialysis.Existe algo de especial a respeito das anormalidades cardíacas e morte súbita e inesperada na epilepsia nos pacientes com insuficiência renal crônica no programa regular de hemodiálise?Resumo -Um dos principais fatores de risco para a morte súbita e inesperada na epilepsia (SUDEP) é a alta freqüência de crises epilépticas. Seguindo este raciocínio, tem sido estabelecido que as crises epilépticas associadas à hemodiálise seja uma complicação do procedimento dialítico. Baseado neste fato, este estudo investigou uma possível associação entre anormalidades cardiovasculares e SUDEP nos pacientes com insuficiência renal crônica em um programa regular de hemodiálise. Para isto, um histórico médico retrospectivo de 209 pacientes foi revisado para avaliar a ocorrência de crises epilépticas e possíveis anormalidades no ECG durante o programa de diálise. Três pacientes apresentaram crises tônico-clonica generalizadas, um apresentou crise parcial com generalização secundária e um apresentou crise não-classificada. Não detectamos anormalidades no ECG e ocorrência de SUDEP em todos os pacientes avaliados. Em conclusão, na presente amostra constatou-se como rara a ocorrência de crises epilépticas e SUDEP. Provavelmente, o número reduzido de casos avaliados tenha sido responsável pela não observação de uma relação direta entre SUDEP e as doenças cardiovasculares na hemodiálise.

Epilepsy is the most common acquired chronic neurological disorder; each year about 1 in a 1000 patients with chronic epilepsy die suddenly, unexpectedly, and without explanation, even with postmortem examination (SUDEP). Seizure incidence is approximately 10% in patients with chronic renal failure and hemodialysis-associated seizure has been considered to be a common complication of people on hemodialysis treatment. Considering this, we evaluated the incidence of seizures in 189 patients under dialytic treatment.

This initiative provided information on proteinuria and possible cases of CKD based on a large sampling of the Brazilian population. Proteinuria was detected in 7.3% of these individuals, and such prevalence is similar to that previously described in developed countries.

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