Neurologic Presentations of Renal Diseases

Lacerda, Glenda Corrêa Borges de; Krummel, Thierry; Hirsch, Édouard

doi:10.1016/j.ncl.2009.09.003

Cited by 30 publications

(17 citation statements)

References 101 publications

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“…Severe cognitive decline in kidney disease and uremic encephalopathy, can be associated with clinical symptoms of cortical excitability such as epileptic seizures, myoclonus, and asterixis …”

Section: Disorders Of the Central Nervous System In Ckdmentioning

confidence: 99%

The nature, consequences, and management of neurological disorders in chronic kidney disease

Jabbari

Vaziri

2017

Hemodialysis International

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Perhaps no other organ in the body is affected as often and in as many ways as the brain is in patients with chronic kidney disease (CKD). Several factors contribute to the neurological disorders in CKD including accumulation of uremic toxins, metabolic and hemodynamic disorders, oxidative stress, inflammation, and impaired blood brain barrier among others. The neurological disorders in CKD involve both peripheral and central nervous system. The peripheral neurological symptoms of CKD are due to somatic and cranial peripheral neuropathies as well as a myopathy. The central neurological symptoms of CKD are due to the cortical predominantly cortical, or subcortical lesions. Cognitive decline, encephalopathy, cortical myoclonus, asterixis and epileptic seizures are distinct features of the cortical disorders of CKD. Diffuse white matter disease due to ischemia and hypoxia may be an important cause of subcortical encephalopathy. A special and more benign form of subcortical disorder caused by brain edema in CKD is termed posterior reversible encephalopathy. Subcortical pathology especially when it affects the basal ganglia causes a number of movement disorders including Parkinsonism, chorea and dystonia. A stimulus-sensitive reflex myoclonus is believed to originate from the medullary structures. Sleep disorder and restless leg syndrome are common in CKD and have both central and peripheral origin. This article provides an overview of the available data on the nature, prevalence, pathophysiology, consequences and treatment of neurological complications of CKD.

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Section: Disorders Of the Central Nervous System In Ckdmentioning

confidence: 99%

The nature, consequences, and management of neurological disorders in chronic kidney disease

Jabbari

Vaziri

2017

Hemodialysis International

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“…It is well known that the prevalence of uremic polyneuropathy (UP) in patients with CKD is high and varies between 60 and 100 % [1][2][3][4]. UP is one of the most common neurological disorders associated with CKD.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, in CKD, mononeuropathies and ischemic monomelic neuropathy related to arteriovenous (AV) fistulas are often described [1,3]. Glomerular filtration rates of <12 ml/min and increased creatinine levels are associated with increased rates of UP [4,5].…”

Section: Introductionmentioning

confidence: 99%

A neurophysiological study of large- and small-diameter nerve fibers in the hands of hemodialysis patients

et al. 2015

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“…Judiciously tailored renal replacement therapy may avoid these complications, whereas others may emerge from these very therapies with overlapping clinical pictures. This makes an already complex management of renal patients even more difficult and asks for tight collaboration between nephrologists and neurologists [13].…”

Section: Resultsmentioning

confidence: 99%

Demyelination and neurodegenerative changes in serum IgG antibodies to GM1, GD1a and GM3 gangliosides in a patient on dialysis

Kolyovska¹,

Pavlova²,

Илиев³

et al. 2017

Neurol Disord Therap

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During the last two decades, an enormous effort has been made to discover biological markers of neuronal damage to effective response to therapy. Gangliosides a family of acidic glycosphingolipids are highly represented in the nervous system. Their spectra show considerable changes in pathological conditions. The complex of anti-ganglioside antibodies may be useful diagnostic and prognostic tool of markers for demyelination (GM1), neurodegeneration (GD1a)and(GM3) correlates with the loss of integrity of the blood brain barrier (BBB). Additionally, patients with renal failure may manifest a variety of neurologic disorders.Dialysis itself is associated with at least three distinct disorders of the central nervous system, including the dialysis disequilibrium syndrome, dialysis dementia, and progressive intellectual dysfunction. Our case studyinvolves a patient on dialysis, a 72-years old woman, as an example of long-term toxicity. She was on dialysis for 1,5 years. The values of IgG anti-GM1, anti-GD1a and anti-GM3 antibodies titers in the blood serum were detected by ELISA. Significantly elevated serum IgG anti-GM1 antibodies titers were detected in our patient. The value of the titer of IgG antibodies against GM1 showed the presence of weak demyelination, increasing with dialysis treatment but not neurodegeneration. On the other hand, other biomarkers were indicative of the preserved integrity of the BBB since IgG titers of antiGD1a and anti-GM3 antibodies were in norm.The patient had many signs that show and prove symptoms of encephalopathy.Neurologic findings in the patients with uremic encephalopathy (UE) range from normal to a comatose state. Neurologic diseases which are specifically related to uremia and/or dialysis occur with increased frequency in patients with end-stage renal disease on chronic hemodialysis. These include subdural hematoma, electrolyte disorders, vitamin deficiencies, drug intoxication, hypertensive encephalopathy, and acute trace element intoxication. Our observations show that there is a relationship between kidney problems and central nervous system (CNS).

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Neurologic Presentations of Renal Diseases

Cited by 30 publications

References 101 publications

The nature, consequences, and management of neurological disorders in chronic kidney disease

The nature, consequences, and management of neurological disorders in chronic kidney disease

A neurophysiological study of large- and small-diameter nerve fibers in the hands of hemodialysis patients

Demyelination and neurodegenerative changes in serum IgG antibodies to GM1, GD1a and GM3 gangliosides in a patient on dialysis

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