A case in which diabetic uremic syndrome developed in a maintenance hemodialysis patient

Abstract

This case involved a 54-year-old Japanese male, who had a 35-year history of diabetes and a 5-year history of dialysis. He developed acute episodes of mild disturbances of consciousness, and parkinsonism, such as gait disturbance, bradykinesia, dysarthria, etc. Cranial magnetic resonance imaging (MRI) showed vasogenic edematous lesions in the bilateral basal ganglia. He was diagnosed with diabetic uremic syndrome. After about 2 weeks of rehabilitation and supportive therapy, his neurological symptoms and MRI findings had markedly improved. Only a few cases of diabetic uremic syndrome involving maintenance hemodialysis patients have been reported. The pathogenesis of and optimal treatment for this condition are unclear. Based on our patient’s MRI findings, we consider that poorly controlled glycemia and the breakdown of the blood-brain barrier are involved in the onset of this condition.