Neurological complications of dialysis, transplantation, and other forms of treatment in chronic uremia

Abstract

A review of the experience with neurological syndromes seen in patients with chronic renal disease undergoing active therapy with dialysis and transplantation is reported. Hemodialysis is more likely to produce abnormalities of nervous system dysfunction than paritoneal dialysis. Convulsions, encephalop-athies, and psychotic states are frequently seen. Chronic peripheral neuropathies often develop coincident with prolonged dialysis. With transplantation, symptoms may appear related primarily to the systemic phenomena associated with rejection or with the sudden shift of electrolytes when the kidney begins to work. The immunosuppressive drugs and steroids have often been correlated with the appearance of unusual central nervous system infections. Several inactive infections have become clinically symptomatic. Rare neuropathologic curiosities such as pontine myelinosis and selective degeneration of the substantia have also been seen in patients.