Intellectual impairment in chronic renal failure.

English, A.M.; Savage, R. D.; Britton, Peter G.; Ward, M. K.; Kerr, David

doi:10.1136/bmj.1.6117.888

Cited by 62 publications

(20 citation statements)

References 11 publications

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“…At the time of the second CCT scan, all 15 patients had CA, although noneof them evidenced gross psychic, behavioural, or cognitive impairment. Mild intellectual impairment, particularly when attributable to cortical atrophy, is better detected when large groups of patients undergo comprehen sive psychometric testing [19] which we were not able to carry out. Still, we point out that with the exception of patient 3, who died, all of our patients continue to be employed.…”

Section: Discussionmentioning

confidence: 95%

Progression of Cerebral Atrophy in Patients on Regular Hemodialysis Treatment: Long-Term Follow-Up with Cerebral Computed Tomography

Savazzi¹,

Cusmano

Vinci³

et al. 1995

Nephron

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Fifteen patients (10 males, 5 females) on regular hemodialysis treatment (average age 43.6 ± 4.0 years, average time on dialysis 100.7 ± 62.8 months) underwent cerebral computed tomography between 1981 and 1984. Ten patients showed mild cerebral atrophy (CA) on the basis of cortical sulci exceeding 3 mm in breadth and an Evans ratio exceeding 0.31, for a total of 14 degrees of CA (mean 0.9+1). The same 15 patients underwent a second cerebral computed tomography during 1991/92 (101 ± 23.7 months later). At that time, the patients exhibited a degree of CA of 2.6 ± 1.4, for a total of 39 degrees with an overall increase of 25 degrees. Since CA is not detected before the age of 55 years in the normal population, we conclude that the CA in this patient group can only be attributed to uremia-related pathology and that it tends to worsen as regular hemodialysis treatment continues. Nevertheless, no evident cognitive, affective, or behavioural changes were verified in these patients. To our knowledge, this is the first presentation of radiologically documented progression of CA in the same patient population over time.

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Section: Discussionmentioning

confidence: 95%

Progression of Cerebral Atrophy in Patients on Regular Hemodialysis Treatment: Long-Term Follow-Up with Cerebral Computed Tomography

Savazzi¹,

Cusmano

Vinci³

et al. 1995

Nephron

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“…En el área de conocimientos sobre la IRC algunos participantes duplicaron el nivel de conocimientos y todos tuvieron mejores puntajes durante el pos test, en ningún caso se mantuvo la misma puntuación que el pre test. Estos resultados son importantes por que además de que fueron estadísticamente significativos, hay que tomar en cuenta que los pacientes con esta enfermedad por lo general padecen de anemia crónica por lo que a menudo están fatigados, duermen mucho, y su capacidad para retener información nueva puede estar afectada (ver English et al, 1978). Sin embargo durante el entrenamiento hicieron un esfuerzo por estar atentos y cooperadores para lograr comprender la información que se les proporcionaba, también esto puede estar relacionado con el interés que tienen en la información cuando está a su alcance.…”

Section: Discussionunclassified

Diseño, implementación y evaluación de un programa de intervención educativa

Santillán¹

2010

RLMC

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ResumenLa IRC es un padecimiento costoso y complejo que exige del paciente una alta adherencia a la alimentación, la ingesta de líquidos, limpieza e higiene, y toma de medicamentos. La adherencia al tratamiento médico está influida por factores como la información que tiene el paciente y su salud mental. Se ha encontrado que esta población muestra una alta prevalencia de sintomatología depresiva, y pocos conocimientos sobre la propia enfermedad. Objetivo: diseñar y probar los efectos clínicos de un programa de intervención educativa cognitivo conductual para pacientes aceptados en el protocolo de DPCI en los siguientes indicadores: a) sintomatología depresiva, b) ansiedad, c) conocimientos sobre la enfermedad, y d) electrolitos séricos. Método: Se evaluó a seis pacientes pre-diálisis con el Inventario de Depresión de Beck, Inventario de Ansiedad de Beck, prueba de conocimientos sobre IRC y pruebas de laboratorio. Participaron en un entrenamiento de dos fases con un total de diez sesiones. Resultados: Hay cambios estadísticamente significativos en el nivel de conocimientos, usando las pruebas estadísticas de Wilcoxon, de Prueba de los signos, y Mcnemar así como ganancias relativas en los niveles ansiedad y sintomatología depresiva. Discusión: Existen algunas dificultades al trabajar con esta población. Se hacen sugerencias para la implementación de este tipo de intervenciones en el futuro. AbstractESRD is a costly and complex condition that requires from the patient high adherence to renal diet, fluid intake, cleanliness and hygiene, and medication. Adherence to treatment is influenced by factors such as information about the disease, and mental health. Several studies show high levels in prevalence of depression among this population, as well as high levels of misinformation about the disease itself. Purpose: to design and test the clinical effects of an educational program including cognitive behavioral skills for patients accepted the protocol of intermittent peritoneal dialysis in the following indicators: a) depression, b) anxiety, c) knowledge about disease, and d) serum electrolytes (glucose, sodium and potassium). Method: Beck Depression Inventory, Beck Anxiety Inventory a Test about ESRD information, and lab tests were administered to six patients predialysis at a local hospital. The patients received a Two-Phase training that accounted for a total of 10 sessions. Results: Wilcoxon, Test of the signs, and Mcnemar statistic tests showed statistically significant changes in the level of knowledge about the disease. Relative gains are shown in anxiety and depression levels. Discussion: The findings are discussed in the light of the difficulties of working with these population. The author makes suggestions for implementing such interventions in the future.

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“…Dialysis encephalopathy was the first complication linked etiologically to alu minum intoxication [10][11][12][13]17], Character ized by progressive intellectual deterioration, seizures, myoclonic jerks, and speech abnor malities, dialysis encephalopathy as first de scribed was thought to be an invariably fatal condition. However, recent studies indicate the presence of a preencephalopathic state manifested solely by a decline in intellectual capacity and performance [32]. This condi tion and milder forms of dialysis encephalop athy may become stable and even improve after a change to an aluminum-free dialysate together with cessation of aluminum-con taining oral phosphate binders [17,18,[33][34][35], Improvement in aluminum dialysis en cephalopathy and osteomalacia has also been reported after long-term intravenous infusion of deferoxamine (Desferal) [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Release of Aluminum by the Redy Dialysis Cartridge

1983

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Perfusion studies in 9 D-31 Redy acetate dialysis cartridges revealed a significant release of aluminum in a form that could diffuse across a dialysis membrane. 8 azotemic patients undergoing dialysis on the Redy system for periods of 18-36 months developed signs and symptoms of aluminum-induced osteomalacic bone disease, and 6 of them also had symptoms and electroencephalographic abnormalities of dialysis encephalopathy. 7 patients have died with these complications. In view of the significant release of aluminum, the D-31 Redy dialysis cartridge may not be ideal or safe for long-term hemodialysis.

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Intellectual impairment in chronic renal failure.

Cited by 62 publications

References 11 publications

Progression of Cerebral Atrophy in Patients on Regular Hemodialysis Treatment: Long-Term Follow-Up with Cerebral Computed Tomography

Progression of Cerebral Atrophy in Patients on Regular Hemodialysis Treatment: Long-Term Follow-Up with Cerebral Computed Tomography

Diseño, implementación y evaluación de un programa de intervención educativa

Release of Aluminum by the Redy Dialysis Cartridge

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