Abstract
Patients with rapidly progressive uraemia often become confused, due to a combination of uraemia, electrolyte and acid-base disorders, sepsis, the accumulation of drugs and other organ failure. Some groups with pre-existing renal disease are more prone to neurological complications; cerebral venous thrombosis in patients with the nephrotic syndrome, CNS infection in renal transplant recipients, and subarachnoid haemorrhage in adult polycystic kidney disease. Similarly, the incidence of renal failure is increased in patients with bladder dysfunction; spina bifida and multiple sclerosis.
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Keywords
- Cerebral Blood Flow
- Peritoneal Dialysis
- Acute Renal Failure
- Cerebral Perfusion Pressure
- Mean Arterial Blood Pressure
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References
Betz E. Cerebral blood flow: its measurement and regulation. Physiol Rev 1972: 552–95.
Baethmann A, Maier-Hauff K, Kempski O, Unterberg A, Wahl M, Schurer L. Mediators of brain oedema and secondary brain damage. Crit Care Med 1988; 16: 972–8.
Kontos HA, Wei EP. Oxygen dependent mechanisms in cerebral auto-regulation. Ann Biomed Eng 1985; 13: 329–34.
Astrup J, Siesjo BK, Symon L. Thresholds in cerebral ischaemia: the ischaemic penumbra. Stroke 1981; 12: 723–5.
Schmidek HH, Auer LM, Kapp JP. The central venous system. Neurosurgery 1985; 17: 663–78.
Davenport A, Will EJ, Davison AM. The effect of posture on intracranial pressure in patients with fulminant hepatic failure and oligurie renal failure following paracetamol (acetaminophen) self-poisoning. Crit Care Med 1990; 18: 286–9.
Malkison TJ. Veale WL, Cooper KE. Fever and intra-cranial pressures. Brain Res Bulletin 1985; 15: 315–9.
Siesjo BK. Mechanisms of ischaemic brain damage. Crit Care Med 1988; 16: 954–63.
Gotoh O, Asano T, Koide T, Takakura K. Ischamic brain oedema following occlusion of the middle cerebral artery in the rat. 1. The time course of the brain water, sodium and postassium contents and blood-brain barrier permeability to I125 albumin. Stroke 1985; 16: 101–9.
Kagstrom E, Smith M-L, Siesjo BK. Recirculation in the rat brain following incomplete ischaemia. J Cereb Blood Flow Metab 1983; 3: 183–92.
Ede RJ, Gimson AES, Bihari D, Williams R Controlled hyper-ventilation in the prevention of cerebral oedema in fulminant hepatic failure. J Hepatol 1986; 2: 43–51.
Procter HJ, Cairns C, Fillipo D, Palladino GW, Rosner MJ. Brain metabolism during increased intracranial pressure as assessed by niroscopy. Surgery 1984; 96: 273–9.
Tyler HR. Neurologic disorders in renal failure. Am J Med 1968; 44: 734–8.
Niiro M, Kadota K, Asakura T, Simon RP. Changes in cerebral extracellular pH, cerebral blood flow and intracranial pressure induced by hypercarbic ventilation-assessment as a potential in vivo model of cerebral acidosis. No To Shinkei 1994; 46: 639–45.
Scheinberg P. Effects of uraemia on cerebral blood flow and metabolism. Neurology 1954; 4: 101–5.
Bowton DL, Bertels NH, Prough DS, Stum DA. Cerebral blood flow is reduced in patients with sepsis syndrome. Crit Care Med 1989; 17: 399–403.
Guisado R, Arietf Al, Massry SG, Lazarowitz V, Kerian A. Changes in the EEG in acute uraemia: effects of PTH and brain electrolytes. J Clin Invest 1975; 55: 738–45.
Ramachandran S, Ganaikabahu B, Pushparajan K, Wijesekera J. EEG abnormalities in patients with snake bites. Am J Trop Med Hyg 1995; 52: 25–8.
Nau HE, Rimpel J. Multimodality evoked potentials and electroencephalography in severe coma cases. Intensive Care Med 1987; 13: 249–55.
Davenport A, Bramley PN. Cerebral function analysing monitor and visual evoked potentials as a noninvasive method of detecting cerebral dysfunction in patients with acute hepatic and renal failure treated with intermittent machine haemofiltration. Ren Fail 1993; 15: 515–22.
Haranomura H, Takeyama Y, Toyokawa A, Saito Y. Possible involvement of activation of pulmonary macrophages in respiratory failure with acute pancreatitis. Nippon Geka Gekkai Zasshi 1994; 95; 376–81
Davenport A, Goldsmith HJ. Haemofiltration in the management of patients with acute renal failure complicated by raised intracranial pressure. Lancet 1987; i: 216.
Bolton CF. Neuropathies in the critical care unit. Br J Hosp Med 1992; 47: 358–60.
Latronico N, Fenzi F, Recupero D, Guarneri B, Tomelleri G, Tonin P, DeMaria, G, Antonini L, Rizzuto N, Candiani A. Critical illness myopathy and neuropathy. Lancet 1996; i: 1579–82.
Davenport A. Muscle weakness associated with continuous haemofiltration. Intensive Care Med 1989; 15: 328–9.
Zochdane DW, Ramasay DA, Saly V, Shelly S, Moffatt S. Acute necrotising myopathy of intensive care: electrophysiological studies. Muscle Nerve 1994; 17: 285–92.
Van den Noort S, Eckel RE, Brine K, Hrdlicka JT. Brain metabolism in uraemic and adenosine infused rats. J Clin Invest 1968; 47: 2133–9.
Cooper JD. Neurologic abnormalities in patients with acute renal failure. Kidney Int 1976; 10: 556.
Fraser CL, Sarnacki P, Arieff AI. Calcium transport abnormality in uraemic rat brain synaptosomes. J Clin Invest 1985; 76: 1789–1883.
Biasioli S, D’Andrea G, Chiaramonte S et al. The role of neurotransmitters in the genesis of uraemic encephalopathy. Int J Artif Organs 1984; 7: 101–6.
Davenport A, Roberts NB. Amino acid losses during continuous high flux haemofiltration in the critically ill patient. Crit Care Med 1989; 10: 1010–4.
Davenport A, King RFJG, Ironside JW, Will. EJ, Davison AM. The effect of treatment with recombinant human erythropoietin on the histological appearance and glycogen content of skeletal muscle in patients with chronic renal failure treated by regular hospital haemodialysis. Nephron 1993; 64: 89–94.
Dyck PJ, Thomas PK, Griffin JG, Low PA, Podulso J. Peripheral neuropathy 3rd edition. WB Saunders, Philadelphia, USA 1993; 1–25.
Tomlinson BE, Pierides AM, Bradley WG. Central pontine myelinolysis: two cases with associated electrolyte disturbance. Q J Med 1976; 65: 373–7.
Bartholomew LG, Scholz DA. Reversible postoperative neurological. syndromes. JAMA 1956; 22: 831–3.
Clark EC, Thomas D, Baer J, Sterns RH. Depletion of glutathione from brain cells in hyponatraemia. Kidney Int 1996; 49: 447–76.
Boon AP, Carey MP, Salmon MV. Central pontine mylelinolysis is not associated with rapid correction of hyponatraemia. Lancet 1988; ii: 458.
Estol CJ, Faris AA, Martinez AJ, Barmada DDA. Central pontine myelinolysis after liver transplantation. Neurology 1989; 39: 493–6.
Ayus JC, Krothapalli RK, Arieff M. Treatment of symptomatic hyponatraemia and its relation to brain damage: a prospective study. N Engl J Med 1987; 317: 1190–3.
Arieff AL. Management of hyponatraemia. Br Med J 1993; 307: 305–6.
Lamer AJ, Vickers CR, Adu D, Bukels JD, Elias E, Neuberger J. Correction of severe hyponatremia by continuous arteriovenous haemofiltration before liver transplantation. Br Med J 1988; 297: 1514–5.
Cserr HF, DePasquale M, Patlak CS. Regulation of brain water and electrolytes during acute hyperosmolality in rats. Am J Physiol 1987; 253: F522–7.
Betz E, Heuser D. Actions and interactions of cations and anions on pial arteries. Cervos-Navarro J (ed) Advances in Neurology, Raven Press, New York 1978; 20: 390–6.
Davenport A, Worth DP, Will EJ. Hypochloraemic alkalosis after high flux continuous haemofiltration and continuous arteriovenous haemofiltration with dialysis. Lancet 1988; i: 658.
Walser M. Ion association. VI. Interactions between calcium, magnesium, inorganic phosphate, citrate and protein in normal human plasma. J Clin Invest 1961; 40: 723–30.
Kanis JA. Disorders of calcium metabolism. In: Weatherall DJ, Ledingham JGG, Warrell DA (eds). Oxford Textbook of Medicine, 3rd edition. Oxford University Press 1996, 1622–39
Davenport A, Goel S, Mackenzie JC. Treatment of hypercalcaemia with pamidronate in patients with end-stage renal failure. Scand J Urol Nephrol 1993; 27: 447–51.
Davenport A, Will EJ. Hypophosphataemia in acute liver failure. Br Med J 1988; 296: 131.
Lam CN, McNeish AS, Gibson AMM. Nephrotic syndrome associated with. complement deficiency and staphylococcal albus bacteraemia. Scot Med J 1969; 14: 86–8.
Davenport A, Dealler SF. The epidermo-peritoneal potential in patients treated with continuous ambulatory peritoneal dialysis. Int J Artif Organs 1993; 16: 71–4.
Zunin C, Castellani A, Olivetti G, Marini G, Gabriele PW. Membranoproliferative glomerulonephritis associated with infected ventriculoatrial shunt: report of two cases recovered after removal of shunt. Pathologica 1977; 69: 27–305.
Partriarca PA, Lauer BA. Ventriculoperitonal shunt associated infection due to Haemophilus influenzae. Paediatr 1980; 65: 1007–9.
Humphreys MH. Human immunodeficiency virus-associated glomerulosclerosis. Kidney Int 1995, 48: 3 1120.
Detwiler RK, Falk RJ, Hogan SL, Jennette JC. Collapsing glomerulopathy: a clinically and pathologically distinct variant of focal segmental glomerulosclerosis. Kidney Int 1994; 45: 1416–24.
Davenport A, Goel S, Mackenzie JC. Neurotoxicity of acyclovir in patients with end-stage renal failure treated with continuous ambulatory peritoneal dialysis (CAPD). Am J Kidney Dis 1992; 20: 647–9.
Morgan O StC, Rodgers-Johnson P, Mora C, Char G. HTLV-1 and polymyositis in Jamaica. Lancet 1989; ii: 1184–7.
Fahal IH, Murray N, Chu P, Bell GM. Acute renal failure during interferon treatment. Br Med J 1993; 306: 973.
Parke MG, Atkinson B, Ucci A, Levey AS. Rapidly progressive glomerulonephritsis after immunotherapy for cancer. J Am Soc Nephrol 1995; 5: 1740–4.
Whiteneck, GG, Adler C, Carter RE, Wagner KA. Mortality, morbidity and pyschosocial outcomes of persons with spinal cord injured more than 20 years ago. Paraplegia 1992; 30: 617–30.
Bannister CM, Tew B (ed). Current concepts in spina bifida and hydrocephalus. Mac Keith Press, London, UK 1991; 46–58.
Joseph DB, Bauer SB, Colodny AH, Mandell J, Retik AB. Clean, intermittent catheterisation of infants with neurogenic bladder. Paediatr 1989; 84: 78–82.
Rosenberg H. Clinical presentation of malignant hyperthermia. Br J Anaesthes 1988; 60: 268–73.
Willner JH, Cern CJ, Wood DS. Malignant hyperthermia: abnormal cyclic AMP metabolism in skeletal muscle. Neurology 1979; 29: 557–63.
Velamoor VR. Progression of symptoms in neuroleptic malignant syndrome. J Nerve Mental Dis 1994; 182: 168–73.
Hawkins DA. Physical complications of drug abuse. In: Weatherall DJ, Ledingham JGG, Warrell DA (eds). Oxford Textbook of Medicine, 3rd edition. Oxford University Press 1996, 4280.
Winney RJ, Kean DM, Best JJK, Smith MA. Changes in brain water with dialysis. Lancet 1986; 11: 1107–8.
Davenport A, Finn R, Goldsmith HJ. Management of patients with renal failure complicated by cerebral oedema. Blood Purif 1989; 7: 203–9.
Kennedy AC, Linton AL, Eaton JC. Urea levels in cerebrospinal fluid after haemodialysis. Lancet 1962; i: 410–11.
Arieff AI. Dialysis disequilibrium syndrome: current concepts on pathogenesis and prevention. Kidney Int 1994; 44: 629–35.
Rosen SM, O’Connor K, Shaldon S. Haemodialysis disequilibrium. Br Med J 1964; 2: 672–5.
Pappius HM, Oh JH, Dossetor JB. The effects of rapid haemodialysis on brain tissues and cerebrospinal fluid of dogs. Can J Physiol 1967; 45: 129–47.
Arieff AI, Guisado R, Massry SG, Lazarowitz VC. Central nervous system pH in uraemia and the effects of haemodialysis. J Clin Invest 1976; 58: 306–11.
Wilkinson SP, Weston MJ, Parsons V, Williams R. Dialysis in the treatment of renal failure in patients with liver disease. Clin Nephrol 1977; 8: 287–92.
Gilliland KG, Hegstrom RM. The effect of haemodialysis on cerebrospinal fluid pressure in uraemic dogs. Trans Am Soc Artif Intern Organs 1963; 9: 44–50.
Peterson H deC, Swanson AG. Acute encephalopathy occurring during haemodialysis. Arch Intern Med 1964; 113: 877–80.
Randall RE Jr, Singh R, Laster J, Belle C, Setter JG. Increased intracranial pressure from unsustained levels of plasma mannitol during haemodialysis. J Lab Clin Med 1967; 70: 129–37.
Leonard A, Shapiro F. Subdural haematoma in regularly haemodialysed patients. Ann Intern Med 1975; 82: 650–8.
Weber DL, Reagan T, Leeds M. Intracerbral haemorrhage during haemodialysis. New York State J Med 1972; 7: 1853–4.
Giammarco RA, Goldberg F. Intracranial pressure monitoring during haemodialysis. Int J Paediatr Nephrol 1981; 2: 197–200.
Bertrand YM, Hermant A, Mahieu P, Roels J. Intracranial pressure changes in patients with head trauma during haemodialysis. Intensive Care Med 1983; 9: 321–3.
Yoshida S, Tajika T, Yamasaki N, Tanikawa T, Kitamura K, Kubo K, Lyden PD. Dialysis disequilibrium syndrome in neurosurgical patients. Neurosurgery 1987; 20: 716–21.
Kopitnik TA, deAndrade R, Gold MA, Nugent GR. Pressure changes within a chronic subdural haematoma during haemodialysis. Surg Neurol 1989; 32: 289–93.
Usui Y, Tamaki SI, Hashizume M, Mukoyama M, Matuo T. A case with chronic renal haemodialysis and intracranial hypertension: a study on CSF dynamics 1989; 4: 397–404.
Krane NK. Intracranial pressure measurement in a patient undergoing haemodialysis and peritoneal dialysis. Am J Kid Dis 1989; 13: 336–9.
Gondo G, Fujitsu K. Kuwabara T, Mochimtitsu Y, Ishiwata Y, Oda H, Takagi N, Yamashita T, Fujino H, Kim I, Nakajima F. Comparison of five modes of dialysis in neurosurgical patients with renal failure. Neurol Med Chir (Tokyo) 1989; 29: 1125–31.
Hirano K, Ishii R, Suzuki Y, Kikuoka M, Hirano H, Ohsawa G, Ohtsuka R. Itoh Y. Neurosurgical management of dialyzed patients. Neurol Med Chir (Tokyo) 1991; 31: 899–904.
Silk DBA, Trewby PN, Chase RA, Mellon PJ, Hanid MA, Davies M, Langley PG, Wheeler PG, Williams R. Treatment of fulminant hepatic failure by polyacrylonitrile membrane haemodialysis. Lancet 1977; ii: 1–3.
Lee WM. Acute liver failure. Am J Med 1994; 96: suppl IA: 3S–9S.
Bidwell G, Sherrard D, Mathews M. Peritoneal dialysis: a temporizing means for haemodialysis patients with subdural haematomas. Nephron 1977; 18: 352–3.
Mactier RA, Dobbie JW, Khanna R. Peritoneal dialysis in fulminant hepatic failure. Perit Dial Bull 1986; 4: 199–202.
Davenport A. Continuous forms of haemofiltration and dialysis in patients with liver failure. Am J Kidney Dis 1996; 28: 562–7.
Gotloib L, Mines M, Garmzo L, Varka I. Hiemodynamic effects of increasing intra-abdominal pressure in peritoneal dialysis. Perit Dial Bull 1981; 1: 41–3.
Bunchman TE, Meldrum MK, Meliones JE, Sedman AB, Walters MB, Kershaw DB. Pulmonary function variation in ventilator dependent critically ill infants on peritoneal dialysis. Adv Perit Dial 1992; 5: 75–8.
Mutimer DJ, Burra P, Neuberger JM, Hubsher S, Buckets JAC, Mayer AD, McMaster P, Elias E. Managing severe alcoholic hepatitis complicated by renal failure. Q J Med 1993; 86: 649–56.
Kishimoto T, Yamagami S, Tanaka H, Ohyima T, Yamamoto T, Yamakawa M, Nishino M, Yoshimoto S, Maekawa M. Superiority of haemofiltration to haemodialysis for treatment of chronic renal failure: comparative studies between haemofiltration and haemodialysis on dialysis disequilibrium syndrome. J Artif Organs 1980; 4: 86–93.
Quellhorst EA, Schuenemann B, Hildebrand U, Falda Z. Response of the vascular system to different modifications of haemofiltration and haemo-dialysis. Proc EDTA 1980; 17: 197–204.
Davenport A, Will EJ, Davison AM. Early changes in intracranial pressure during haemofiltration treatment in patients with grade IV hepatic encephalopathy and acute oliguric renal failure. Nephrol Dial Transplant 1990; 5: 192–8.
Davenport A, Will EJ, Davison AM. Effect of renal replacement therapy on patients with combined acute renal and fulminant hepatic failure. Kidney Int 1993; 43: Suppl 41: 5245–51.
Kramer P, Wigger W, Rieger J, Mathaei D, Cheler F. Arteriovenous haemofiltration: a new and simple method for the treatment of overhydrated patients resistant to diuretics. Klin Wschr 1977; 55: 1121–2.
Davenport A, Will EJ, Losowsky MS, Swindells S. Continuous arteriovenous haemofiltration in patients with hepatic encephalopathy and renal failure. Br Med J 1987; 295: 1028.
Rakela J, Kurtz SB, McCarthy JT, Krom RAF, Baldus WP, Mcrill DB, Perrault J, Milliner DS. Postdilution hemofiltration in the management of acute hepatic failure: a pilot study. Mayo Clin Proc; 1988; 63: 113–8.
Trottier SJ, Veremakis C, O’Brien J, Auer AI. Femoral deep vein thrombosis associated with central venous catheterisation: results from a prospective, randomized trial. Crit Care Med 1995; 23: 2–59.
Storck M, Hartl WH, Zimmerer E, Inthorn D. Comparison of pump-driven and spontaneous continuous haemofiltration in postoperative acute renal failure. Lancet 1991; 337: 452–5.
Dyson EH, Johnston P, Prabhu P, Goutcher E, Davison AM, Will EJ. Volumetric control of continuous haemodialysis in multiorgan failure. Artif Organs 1991; 16: 439–42.
Lazarus JM, Owen WF. Role of bioincompatibility in dialysis morbidity and mortality. Am J Kidney Dis 1994; 24: 1019–32.
Schiffl H, Lang SM, König A, Strass T, Haider MC, Held E. Biocompatible membranes in acute renal failure: prospective case controlled study. Lancet 1994; 344: 570–772.
Davenport A, Will EJ, Davison AM. Membrane biocompatibility: effects on cardiovascular stability in patients on haemofiltration. Kidney Int 1993; 43: (suppl 41): S230–4.
Gueugniaud PY, Bertin-Maghit M, Hirschaner C, Petit P. Removal of cytokines in septic patients using continuous veno-venous haemofiltration. Crit Care Med 1994; 22: 717.
Davenport A, Will EJ, Davison AM. Comparison of the use of standard heparin and prostacyclin anticoagulation in spontaneous and pump-driven extracorporeal circuits in patients with combined acute renal failure and hepatic failure. Nephron 1994; 66: 431–7.
Jeffrey RF, Khan AA, Douglas JT, Will EJ, Davison AM. Anticoagulation with low molecular weight heparin (fragmin) during continuous haemodialysis in the intensive care unit. Artif Organs 1993; 17: 717–20.
Ohtake Y, Hirasawa H, Sugai T, Oda S, Shiga H, Matsuda K, Kitamura N. Nafamostat mesylate as anticoagulant in continuous haemofiltration and continuous haemodiafiltration. Contrib Nephrol 1991; 93: 215–7.
Mehta, RL, McDonald BR, Ward DM. Regional citrate anticoagulation for continuous arteriovenous haemodialysis. Contrib Nephrol 1991; 93: 210–4.
Flanigan MJ, Pillsbury L, Sadewasser G, Lim VS. Regional haemodialysis anticoagulation: hypertonic trisodium citrate or anticoagulant citrate dextose-A. Am J Kidney Dis 1996; 27: 519–24.
Wendon JA, Harrison PM, Keays R, Gimson AES, Alexander GJM, Williams R. Effects of vasopressor agents and epoprostenol on systemic haemodynamics and oxygen transport in fulminant hepatic failure. Hepatol 1992; 15: 1067–71.
Bellomo R, Teede H, Boyce N. Anticoagulant regimens in acute continuous haemodiafiltration: a comparative study. Intensive Care Med 1993; 19: 329–32.
Gretz N, Quintel M, Ragaller M, Odenwaldter W, Bender HJ, Rohmeiss P, Strauch M. Low-dose heparinisation for anticoagulation in intensive care patients on continuous haemofiltration. Contrib Nephrol 1991; 116: 130–5.
Veech RL, Fowler RC. Cerebral dysfunction and respiratory alkalosis during peritoneal dialysis with D-lactate containing dialysis fluid. Am J Med 1986; 82: 572–3.
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Davenport, A. (1998). Neurological disorders in patients with acute renal failure. In: Critical Care Nephrology. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5482-6_92
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