Dialysis Encephalopathy

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Abstract
Renal failure and its treatment are fraught with neurologic complications. Uremic encephalopathy and peripheral neuropathy complicate untreated renal failure.1,2 Disequilibrium syndrome, various metabolic encephalopathies resulting from electrolyte disorders, and subdural hematoma are well documented problems encountered in either acute or chronic dialysis.1,3,4 Although difficult to define with precision, the syndrome of dialysis encephalopathy appears to be a distinct syndrome by virtue of its speech impairment disproportionate to depressed sensorium, its intermittent but recurrent nature, and the uniform absence of other known causes of the neurologic disturbances. Additionally, electroencephalographic changes may be both sensitive and specific for the syndrome.5-9 Since the initial observations reported by Alfrey et al,5 several investigators have reported a considerable number of cases among patients receiving dialysis in specific dialysis centers.6,7,10 This suggested that the syndrome was occurring in outbreak form, which stimulated speculation that an infectious agent—possibly a slow virus, might

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