Korean J Nephrol.  2003 Sep;22(5):618-621.

ReVersible MRI Changes in a Patient with Uremic Encephalopathy

• Jang MH
• Choi HJ
• Cho JH
• Kwon HM
• Kim CD
• Park SH
• Cho DK
• Kim YL

Abstract

Uremic encephalopathy is a well-known complication in uremia and may result from changes of cerebral metabolism due to uremic toxins. Specific morphological changes have not been observed and pathogenesis is still unclear. We experienced a case with uremic encephalopathy in whom reVersible abnormalities were observed on brain magnetic resonance image (MRI). A 61-year-old man with chronic renal faliure due to diabetic nephropathy started automated peritoneal dialysis (APD) one year ago (therapy time: 10 hours, number of cycles: 5, fill volume per cycle: 2 L). He developed gait disturbance and dysarthria after he dwelled icodextrin contained 2 L dialysate over night instead of APD. In that time, his weekly Kt/V and creatinine clearance were 1.5 and 87.5 L/week/1.73 m2, respectively. On brain MRI, low signal in T1 image and high signal in T2 image were seen in putamen and globus pallidus bilaterally. Insufficient peritoneal dialysis adequacy was documented, and the patient was switched from APD to continuous ambulatory peritoneal dialysis (CAPD). After than, his symptom gradually improved. On follow-up MRI 2 months later, previous lesion has disappeared.

Keyword

Uremic encephalopathy; MRI; Adequacy

MeSH Terms

Brain
Creatinine
Diabetic Nephropathies
Dysarthria
Follow-Up Studies
Gait
Globus Pallidus
Humans
Magnetic Resonance Imaging*
Metabolism
Middle Aged
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory
Putamen
Uremia
Creatinine