Morphologic cerebral changes in patients undergoing dialysis for renal failure

Cranial computed tomographic examinations were performed on 22 patients before and after hemodialysis, and on 11 of those patients 8 months later. In 11 cases widening of the cerebrospinal fluid spaces due to brain atrophy was recognizable. Density measurements disclosed decreased absorption of cerebral parenchyma after dialysis in 73% of the cases. This finding is partly explained by cerebral edema or hydration, although the necessary contemporaneous narrowing of cerebrospinal fluid spaces existed in only six patients (27%). Long-term follow-up studies have not displayed any realizable changes in results. Finally, despite striking computed tomographic findings and alterations after dialysis, only mild neurologic symptoms or disequilibrium syndromes have been registered.