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Related Experiment Videos

Dialysis dementia -- the Chicago experience

S D Mahurkar, E C Smith, B H Mamdani

    Journal of Dialysis
    |January 1, 1978
    PubMed
    Summary

    Dialysis dementia, a neurological condition, affected 20 out of 160 patients between 1972-1976. High aluminum levels in city water were linked to this outbreak in maintenance dialysis patients.

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    Area of Science:

    • Neurology
    • Nephrology
    • Environmental Health

    Background:

    • Dialysis dementia is a severe neurological disorder observed in patients undergoing maintenance dialysis.
    • An outbreak occurred between 1972 and 1976, affecting a significant portion of the dialysis population.

    Purpose of the Study:

    • To investigate the characteristics and potential causes of dialysis dementia.
    • To identify risk factors and understand the progression of the disease.

    Main Methods:

    • Observational study of 160 maintenance dialysis patients over four years (1972-1976).
    • Clinical assessment of neurological symptoms, biochemical studies, electroencephalograms (EEG), brain scans, and cerebrospinal fluid (CSF) dynamics.
    • Epidemiological investigation of water quality.

    Main Results:

    • Twenty patients developed dialysis dementia, characterized by mental deterioration, speech disturbance, apraxia, and myoclonus.
    • EEG showed progressive slowing, often preceding neurological symptoms. CSF dynamics were altered in some patients.
    • High aluminum levels in city water correlated with the outbreak period; routine biochemical tests and osteodystrophy were not prominent.

    Conclusions:

    • Dialysis dementia is an insidious and fatal neurological condition in dialysis patients.
    • Altered cerebrospinal fluid dynamics and high environmental aluminum exposure are implicated in the pathogenesis.
    • Further research into aluminum toxicity in dialysis patients is warranted.

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