Nervous system diseases renal failure

When kidney failure uremia disease of the nervous system, almost 100% of the patients have neurological symptoms. Lack of energy, fatigue, dizziness, headache.

(1) uremic encephalopathy: clinical manifestations of non-specific, the initial presentation of apathy, lack of appetite, fatigue, insomnia. Symptoms aggravated with disease progression, there orientation, calculation disorder, even insanity. Lap-like tremor is an important indicator of diagnosis of uremic encephalopathy, often associated with disturbance of consciousness simultaneously. Myoclonus such as muscle, proximal limb muscles appear on the face, this is late symptoms of encephalopathy, coma exist almost the same time, convulsions can occur simultaneously. Epileptic seizures can be focal or generalized grand mal seizures, status epilepticus if the latter can lead to sudden death. EEG is helpful in judging the condition of uremia, can be used as a dynamic observation methods, the main findings of slow wave, while an increase in common θ and δ waves.

According to "the molecules' hypothesis proposed in 1972 Babb, suggesting nervous system diseases and certain molecular substances (eg neurotoxins) accumulate in the body related. Nerve toxins accumulate in the body and water, electrolytes, acid-base balance, resulting in brain blood circulation disorders, brain and peripheral nerve cell metabolism, causing uremic central and peripheral neuropathy. Dialysis, dialysis adsorbent can improve symptoms of encephalopathy. CRF encephalopathy occurred during hemodialysis, and said uremic encephalopathy should be identified. As disequilibrium syndrome, dialysis encephalopathy. Disequilibrium syndrome refers to a few hours, headache, nausea, unconsciousness and other symptoms of encephalopathy after hemodialysis. Its causes are: between blood and brain tissue formation after dialysis osmotic pressure difference, or osmotic gradient polymer material, resulting in the transfer of water to the brain tissue of cerebral edema. Dialysis encephalopathy occurs in long-term hemodialysis patients, the occurrence of progressive neuropsychiatric symptoms; manifested as language disorders, depression, dementia and other symptoms may be associated with an increased brain aluminum concentration.

(2) uremic peripheral neuropathy: When GFR <12ml / min, numbness of the limbs, lower limbs appear strange sense, was ant-aliasing or tingling, itching, or walking legs need after mitigation activities, called restless leg Comprehensive sign. Lower limb extremities may also appear burning and other peripheral nerve performance. In end-stage uremia, brain symptoms can also be found, such as the pupil asymmetry, facial paralysis, abducens nerve palsy, hearing impairment, deafness, throat and tongue muscle weakness, difficulty urinating, urinary retention.

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