Neurological complications of renal dialysis and transplantation

Karunaratne, Kushan; Taube, David; Khalil, Nofal; Perry, Richard; Malhotra, Paresh

doi:10.1136/practneurol-2017-001657

Cited by 18 publications

(14 citation statements)

References 47 publications

(32 reference statements)

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“…com/index_renal.htm) provides such dosing guidance. If in doubt, advice from a specialist renal pharmacist is strongly recommended [3]. This was first described in 1962 but is now rare, because of changes in dialysis regimes and increasing frequency of dialysis sessions.…”

Section: Drug Toxicity In Patients On Dialysis and Renal Transplantmentioning

confidence: 99%

“…To prevent the syndrome, the serum sodium concentration should be corrected slowly, not faster than 6-8 mmol/l per day by reducing dialysate sodium or reducing the flow rate during dialysis [3].…”

Section: Central Pontine Myelinolysismentioning

confidence: 99%

“…Specialist renal dieticians can provide advice to improve nutritional intake to prevent the condition. Consideration of the diagnosis and rapid recognition, with initiation of thiamine replacement if it develops, is critical to minimise any long-term neurological deficits [3].…”

Section: Wernicke's Encephalopathymentioning

confidence: 99%

“…ACE inhibitors, magnesium supplementation, volume maintenance, electrolyte and blood pressure control may provide some prophylactic benefit [61•, 63]. [3]). Empiric treatment aimed at covering the most likely pathogens should be started early in patients with suspected CNS infection.…”

Section: Dialysis Headachementioning

confidence: 99%

“…Renal failure is associated with several neurological complications including cerebrovascular disease, cognitive impairment, uraemic encephalopathy, peripheral neuropathy and myopathy [3]. Dialysis only partially corrects the pathophysiological abnormalities that contribute to these, and renal replacement therapy (dialysis and renal transplantation) is associated with other neurological complications.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Central Nervous System Complications of Renal Dialysis and Transplantation

Dahdaleh

Malhotra

2019

Curr Treat Options Neurol

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Purpose of review Most clinical neurologists will have come across individuals receiving renal replacement therapy who have developed a neurological complication, and neurologists working in, or close to, hospitals with a Renal Unit will be very aware of the range of central nervous system (CNS) complications that may develop in these patients. These can often be difficult to differentiate from disorders relating to renal failure or systemic conditions leading to kidney disease and can in fact arise from the interaction between underlying disease and the side effects of treatment. Patients with renal disease frequently have multiple comorbidities, and it is necessary to take a generally inclusive approach to diagnosis and treatment. Recent findings Unfortunately, there is a lack of specific high-quality evidence for a number of CNS complications of renal replacement therapy. Here, we review the major CNS complications of dialysis and transplantation, discussing evidence for treatments where available and detailing standard management approaches where evidence is scarce. Summary Given the lack of specific evidence for interventions in the treatment of CNS complications of renal replacement therapy, it is often necessary to take an individualised approach based on comorbidities and applying findings from the general population. In these complex patients, we must stress the importance of collaborative working between neurologists and renal physicians when treating this complex patient group.

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Section: Drug Toxicity In Patients On Dialysis and Renal Transplantmentioning

confidence: 99%

Section: Central Pontine Myelinolysismentioning

confidence: 99%

Section: Wernicke's Encephalopathymentioning

confidence: 99%

Section: Dialysis Headachementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations