Dialysis Encephalopathy Relieved by Hemofiltration: A Case Report and a Review

Abstract

KANEDA, H., TAKADA, K., MAETA, T., SHITOMI, K. and MURATA, T. Dialysis Encephalopathy Relieved by Hemofiltration: A Case Report and a Review. Tohoku J. exp. Med., 1983, 139 (2), 221-222-Dialysis encephalopathy (DE) is characterized by a symptom complex of stuttering speech, myoclonic jerk, fit, psychosis and dementia observed in patients undergoing hemodialysis. Its cause is believed to be accumulation of aluminium in the brain. No effective treatments are known to date. A female patient, 61 years of age, with DE was successfully treated by hemofiltration in our hospital. She had been hemodialysed twice weekly. At 13 months after the start of hemodialysis, she began to suffer from finger tremor, myoclonic jerk, stuttering and irrelevant speeches and disorientation. Her EEG showed, from time to time, slow waves with high amplitude which were compatible with DE. Soon after the start of hemofiltration instead of hemodialysis, these symptoms and EEG abnormalities were dramatically improved. She had received aluminium hydroxide (4-6g/day) before and after the development of DE. As for the cause of her DE, it is reasonable to think that the etiological factors can be removed by hemofiltration, but not by hemodialysis, and so their molecular weights may be less than 30, 000. Aluminium itself may not be responsible for the development of her DE.