Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 23 haemodialysis patients, taking regularly aluminium hydroxide (Al(OH)3) of various dosage regimens for more than 18 months, three developed aluminium (Al) related morbidity (fracturing osteopathy 3/3, encephalopathy 2/3, 1/3 died). In 15 patients followed for 14 months after Al(OH)3 withdrawal the previously elevated serum Al concentrations fell and no worsening of osteodystrophy (especially hyperparathyroidism) could be demonstrated. Our data and other reports suggest that oral administration of Al containing phosphate binders causes unacceptable morbidity for an unproven benefit, and should be avoided.
Proc Eur Dial Transplant Assoc 1983
PMID:Risk of orally administered aluminium hydroxide and results of withdrawal. 665 57

Aluminium removal by desferrioxamine chelation has been demonstrated in three long-term haemodialysis patients with dialysis encephalopathy and fracturing renal osteodystrophy. Aluminium concentrations in serum and in both bone marrow and bone trabeculae, determined separately in transiliac biopsy specimens, fell significantly over the treatment period. Bone aluminium removal was confirmed by specific histochemical staining. In two patients osteomalacia disappeared, and in two patients osteitis fibrosa emerged but improved in one following vitamin D therapy. We conclude that desferrioxamine is capable of mobilising aluminium from bone and that the calcification defect in fracturing renal osteodystrophy may be overcome.
Proc Eur Dial Transplant Assoc 1983
PMID:Treatment of fracturing renal osteodystrophy by desferrioxamine. 687 34

Thirteen patients are described who had 15 encephalopathic episodes complicating severe rejection crises following renal transplantation. Comparison was made with control rejection episodes in the same patients in which encephalopathy did not occur. The severity of the rejection episodes as measured by the rise in serum creatinine was significantly greater (p less than 0.05) in those episodes with encephalopathy than in control episodes. There was no difference from controls when comparison was made of mean arterial blood pressure (MABP) or rate of rise of MABP at the time of the encephalopathy. There was no significant difference in serum potassium, sodium and calcium, weight gain/fluid retention and immunosuppressive therapy in the two groups. Effective treatment of rejection and control of fits, hypertension and fluid retention produced rapid recovery without late sequelae.
Proc Eur Dial Transplant Assoc 1981
PMID:Rejection encephalopathy. 703 66

Twelve patients being treated by intermittent haemodialysis developed a severe microcytic hypochromic anaemia despite adequate iron supplements. Serum ferritin concentration was normal or high. Seven patients later developed histologically proven fracturing osteomalacia and one a fatal encephalopathy. Plasma aluminium concentration was high in all twelve patients and the source was the water used to make up dialysis fluid. Following dialysis with aluminium free dialysis fluid, plasma concentrations of aluminium fell, red cell morphology returned to normal and haemoglobin rose. We believe that in addition to causing encephalopathy and osteomalacia, aluminium causes a microcytic hypochromic anaemia. This anaemia appears to be the first manifestation of aluminium intoxication and is reversed by removing the source of aluminium.
Proc Eur Dial Transplant Assoc 1980
PMID:Reversible microcytic hypochromic anaemia in dialysis patients due to aluminium intoxication. 724 73

The success of maintenance haemodialysis in the 1960s was blighted by the problem of anaemia. Treatment with iron, folic acid, androgens and transfusions did no more than minimize its effects. The need for a renewable source of erythropoietin was appreciated very early but the hope took 25 years to realize. Cloning and expression of the human gene was achieved in 1984 and clinical trials planned even before the descriptions of the recombinant hormone were published. The Amgen material was tested in parallel studies in Seattle and England and by the end of 1986 the efficacy of recombinant human erythropoietin (r-HuEPO) given in large intravenous bolus doses in reversing the anaemia of uraemia was established. The benefits were immediately obvious: relief from transfusion dependence was the unequivocal evidence but the effect on 'wellbeing' though subjective was remarkable. Large clinical trials were completed in Europe and the USA so that r-HuEPO was licensed as a therapeutic drug less than two years later. The pilot studies flagged a number of key issues: hypertension, sometimes with encephalopathy, occurred in patients whose blood pressure was labile before treatment; vascular access failure seemed more frequent and hyperkalaemia was thought to reflect less efficient dialysis. Failure to respond focused attention on iron balance as well as on factors such as infection, aluminium, and hyperparathyroidism. A more clear understanding of the pathogenesis of the anaemia of uraemia was made possible by dissection of the specific effects of the exogenous erythropoietin on erythroid function.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1995
PMID:Historical review on the use of recombinant human erythropoietin in chronic renal failure. 764 3

To evaluate the presence and the severity of uraemic encephalopathy (UE) in regular dialysis treatment patients in relation to dialytic age, pattern reversal visual evoked potentials (PRVEPs) and brainstem auditory evoked potentials (BAEPs) were respectively performed in 86 and 98 patients on haemodialysis for 1-194 months, divided into three subgroups according to dialytic age (group 1, < 5 years of regular dialysis; group 2, 5-10 years; group 3, > 10 years). VEPs in the whole group of 86 patients and in each subgroup with different dialytic age differed significantly from controls for both eyes, 41.7% of whom had pathological P100; no differences were observed between the three subgroups. BAEPs were pathological in 9.7% of the ears and 18.4% of patients. On the right ear the three subgroups were significantly different from controls in the latencies of peaks III and V; subgroup 2 and 3 differed from controls in the I-V interpeak, while the interpeak I-III was different from controls only in subgroup 3. On the left ear the three subgroups differed significantly from controls in the latencies of peak V; subgroup 2 and 3 were significantly different from controls in the latency of peak I; subgroup 3 was different in the peak III latency; subgroup 1 and 3 were different from controls in the interpeak I-V; no differences were observed in BAEPs between the three subgroups with increasing dialytic age. No significant correlations were found between the neurophysiological parameters and some biochemical parameters (urea, creatinine, PTH).(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1993
PMID:Evoked potentials (VEPs and BAEPs) in a large cohort of short- and long-term haemodialysed patients. 827 27

We employed the so-called event-correlated potential (ECP) P300, a neurophysiological test which explores the circuits of attention and memory in the brain and is altered in subjects with a dismetabolic or degenerative encephalopathy, in order to evaluate the cognitive faculty in two groups of uremic patients [18 on continuous ambulatory peritoneal dialysis (CAPD), 15 on hemodialysis (HD)] comparable with respect to age and time on dialysis. The values of latency (msec) of P300 resulted in CAPD patients 356 +/- 26 in CZ (central zero electrodes) and 357.5 +/- 25 in PZ (parietal zero electrodes), not significantly different from the values in normal controls (341 +/- 14.5 in CZ and 340 +/- 15.6 in PZ) and in HD patients postdialysis (354 +/- 24.4 in CZ and 354 +/- 25.6 in PZ). On the contrary, the predialytic values of HD patients (384 +/- 25.6 CZ and 385 +/- 25.5 in PZ) were significantly different from the postdialytic values and from the values of CAPD patients and controls (p < 0.01). These results support the conclusion that HD is able to restore a normal cognitive faculty only transiently in the postdialytic phase, while CAPD maintains this important function steadily close to the normal range, thus being clearly better than HD.
Perit Dial Int 1993
PMID:Better preservation of cognitive faculty in continuous ambulatory peritoneal dialysis. 839 66

Protein malnutrition is now well established as an important contributory factor to the high mortality in peritoneal dialysis (PD) patients. Low dietary protein calorie intake is one of the factors leading to protein malnutrition. If PD patients develop difficulty eating, percutaneous endoscopic gastrostomy (PEG) feeding may prove beneficial in providing adequate nutrition. Studies on the effectiveness of PEG feeding in PD patients are limited to pediatric patients. The objective of the present study was to assess the outcome of PEG feeding in adult patients with end-stage renal disease (ESRD) on PD. We retrospectively reviewed charts from May 1992 to February 2000 of 10 consecutive patients in our center who had had feeding tubes inserted. The patients' ages ranged from 37 to 81 years, with mean age of 65. Of the 10 patients, 7 were male, 5 were diabetic, and 1 was infected with the human immunodeficiency virus. Two patients had cerebrovascular accident (CVA) with dysphagia, 3 had multi-infarct dementia, 2 had anoxic encephalopathy, 2 had dementia, and 1 had calciphylaxis with anorexia. Of the 10 patients, 9 failed to eat because of neurologic disorders. Two patients who had functioning PEG feedings before starting PD had no complications. Only 2 of 8 patients already on PD continued with long-term PD after a PEG was inserted. Both patients whose PD was not interrupted at the time of PEG placement immediately developed peritonitis. Of the 6 patients who were maintained on hemodialysis (HD), 2 developed peritonitis within one week of starting PEG feedings. The other 4 had no complications from PEG feedings while being maintained on HD, but 1 developed peritonitis when PD was resumed. Of the 5 patients who developed peritonitis, 3 experienced fungal peritonitis. In PD patients, PEG feeding is associated with frequent complications. However, PEG placement prior to PD initiation appears to be safe. Maintaining patients on HD for at least 6 weeks appears to decrease the incidence of peritonitis, but does not eliminate it. Use of anti-fungal prophylaxis and maintenance of the patient on HD for longer than 6 weeks may produce better results.
Adv Perit Dial 2001
PMID:Outcome of percutaneous endoscopic gastrostomy feeding in patients on peritoneal dialysis. 1151 Feb 64

Aluminium- or calcium-based phosphate-binding agents traditionally have been used to treat hyperphosphataemia in patients with end-stage renal disease. Although these agents effectively lower serum phosphorus levels, they are associated with serious side effects. Aluminium-based agents are associated with bone toxicity, renal osteodystrophy and encephalopathy, and calcium-based agents increase the risk of hypercalcaemia and cardiovascular calcification. Consequently, there remains a need for new, safe and effective non-calcium-, non-aluminium-based alternative treatments. Fortunately, several new agents are now available or are in the late stages of development, including sevelamer hydrochloride and lanthanum carbonate. Although sevelamer hydrochloride represents a step forward in the management of hyperphosphataemia, it has several drawbacks and is far from being the ideal phosphate binder. Lanthanum carbonate is the most recent non-calcium, non-aluminium phosphate binder to be developed for the treatment of hyperphosphataemia. Animal studies have shown it to be as effective as aluminium, without the associated toxicity. In clinical studies, lanthanum carbonate significantly reduced serum phosphorus levels, compared with placebo. It shows a similar efficacy to calcium carbonate in controlling serum phosphorus levels, but requires lower doses. In addition, lanthanum carbonate is at least as well tolerated as calcium carbonate, but is not associated with hypercalcaemia. Importantly, it has a positive effect on bone histology, with no evolution towards low bone turnover. Lanthanum carbonate, therefore, moves closer to the ideal phosphate binder.
Nephrol Dial Transplant 2004 Mar
PMID:Improving phosphate-binder therapy as a way forward. 1512 50

Fulminant hepatic failure is characterized by the development of severe liver injury with impaired synthetic capacity and encephalopathy in patients with previous normal liver or at least well compensated liver disease. The etiology of fulminant hepatic failure refers to a wide variety of causes, of which toxin-induced or viral hepatitis are most common. In spite of specific therapeutic options in distinctive etiologies, orthotopic liver transplantation is the only therapy proven to improve patient survival in the majority of patients. The outcome is determined by the complications like severe coagulopathy, infections, renal impairment or increased intracranial pressure. The decision for transplantation depends on the possibility of spontaneous hepatic recovery, which may be estimated by several factors. The most important variables for predicting the need of transplantation in fulminant hepatic failure are the degree of encephalopathy, patients age and the underlying cause of liver failure.
Nephrol Dial Transplant 2007 Sep
PMID:Fulminant hepatic failure: etiology and indications for liver transplantation. 1789 Feb 63


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