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Neurophysiological findings and serum aluminium in dialysis encephalopathy
Insights
Elevated serum aluminium levels are linked to dementia and abnormal EEG findings in hemodialysis patients. This study highlights a significant correlation between high aluminium and neurological changes in this population.
Area of Science:
- Nephrology
- Neuroscience
- Toxicology
Background:
- Hemodialysis patients are at risk of aluminium accumulation.
- Aluminium toxicity can affect neurological function.
Purpose of the Study:
- To investigate the correlation between serum aluminium levels and neurological changes in hemodialysis patients.
- To assess the relationship between aluminium levels, dementia, and electroencephalogram (EEG) abnormalities.
Main Methods:
- Serum aluminium levels were measured using flameless atomic absorption spectrophotometry.
- Psychological testing for intelligence quotient (IQ) and clinical observations were used to diagnose dementia.
- Electroencephalogram (EEG) was performed on all patients.
Main Results:
- Six out of 64 hemodialysis patients were diagnosed with dementia.
- Demented patients had significantly higher serum aluminium levels compared to non-demented patients (p < 0.01).
- All demented patients showed abnormal EEGs, and a correlation was found between serum aluminium levels and EEG abnormalities (p < 0.05).
Conclusions:
- Serum aluminium levels are correlated with the development of dementia in hemodialysis patients.
- Elevated aluminium levels are associated with EEG changes, including slow waves and epileptic potentials.
- Neurological complications in hemodialysis patients may be linked to aluminium accumulation.
Abstract:
64 patients on hemodialysis were investigated. The mean duration of dialysis was 43 months. In all the patients, serum aluminium levels, systolic blood pressure (averaged over a period of 6 weeks) and the EEG were investigated. Psychological testing to assess the level of intelligence (IQ) was also performed. The serum aluminium levels have been assayed by flameless atomic absorption (Perkin-Elmer atomic absorption spectrophotometer model 420). In 6 patients, the diagnosis of dementia was made on the basis of psychological testing and clinical observations. The demented patients showed significantly (p less than 0.01) higher aluminium levels (mean 409 microgram/l, SD 235) than the 58 non-demented patients (mean 189 microgram/l, SD 152), whereas the age of the patients, duration of dialysis and blood pressure were the same in both groups. The EEG was abnormal in all 6 demented patients. Only in 23 of the 58 non-demented patients was the EEG pathological (p less than 0.05). A significant correlation was found between serum aluminium levels and the EEG data with regard to bilateral slow waves, focal slow waves and epileptic potentials (p less than 0.05). The EEG, age of the patients, duration of dialysis and blood pressure showed no correlation. Electromyography, nerve conduction velocity and latency showed no correlation with aluminium levels or dementia. It can be concluded from our findings that in dialyzed patients there is a correlation between serum aluminium levels and the appearance of dementia and EEG changes.