Nervous system disorders in dialysis patients

Abstract

Neurologic complications are frequently encountered in dialysis patients. These may be due to the uremic state or to dialysis therapy, and require careful assessment. With longer survival of dialysis patients, these neurologic complications may significantly affect morbidity, mortality, and patients' well-being. Central nervous system involvement includes uremic encephalopathy as well as dialysis disequilibrium disorder. Both are rarely seen because of current improved understanding of their pathogenesis and treatment. Manifestations of atherosclerosis, stroke, and other neuropathies are present in this population and are not significantly altered by dialysis therapy. In recent years, increasing numbers of sleep disorders are being recognized. Peripheral nervous system involvement is also noted, including myopathy and related categories. In this chapter, we address clinical and pathophysiologic aspects of nervous system disorders in dialysis patients while discussing available therapeutic options to address the neurologic involvement.

Keywords: Uremic encephalopathy; aluminum neurotoxicity; cognitive disorders in dialysis; dialysis dementia; dialysis disequilibrium; ischemic strokes in dialysis; posterior reversible leukoencephalopathy (PRLS) syndrome; restless legs syndrome; sleep disorders in dialysis.