UREMIC ENCEPHALOPATHY

Course overview

UREMIC ENCEPHALOPATHY IS A CEREBRAL DYSFUNCTION CAUSED BY THE ACCUMULATION OF TOXINS RESULTING FROM ACUTE OR CHRONIC RENAL FAILURE. THE CLINICAL PRESENTATION IS BROAD, AND THE CLINICAL COURSE IS ALWAYS PROGRESSIVE WHEN UNTREATED. THE SYNDROME LIKELY RESULTS FROM ALTERATIONS IN HORMONAL METABOLISM, RETENTION OF UREMIC SOLUTES, CHANGES IN ELECTROLYTE AND ACID-BASE HOMEOSTASIS, BLOOD-BRAIN BARRIER TRANSPORT, CHANGES IN VASCULAR REACTIVITY, AND INFLAMMATION. THERE ARE NO DIAGNOSTIC CLINICAL, LABORATORY, OR IMAGING FINDINGS, AND OFTEN THE DIAGNOSIS IS MADE RETROSPECTIVELY WHEN SYMPTOMS IMPROVE AFTER DIALYSIS OR TRANSPLANTATION. IF THERE IS NO IMPROVEMENT IN SYMPTOMS AFTER CLEARING TOXIC SOLUTES, A SEARCH FOR OTHER EXPLANATIONS SHOULD BEGIN. THIS ACTIVITY DESCRIBES THE EVALUATION AND TREATMENT OF UREMIC ENCEPHALOPATHY AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE CARE OF PATIENTS WITH THIS CONDITION.