Influence of end-stage renal failure and hemodialysis on event-related potentials

Chronic renal failure frequently causes uremic encephalopathy with impairment of different cognitive functions, but the pathophysiology of uremic encephalopathy is still unknown. We measured visually evoked event-related potentials (ERPs) in 33 neurologically asymptomatic patients before and after they underwent hemodialysis and compared their data with those of a strictly age-matched healthy control group. Before hemodialysis, the patients' P3 latency was significantly increased and P3 amplitude was significantly decreased as compared with that of the healthy control group. After hemodialysis, P3 latency of the patients showed a significant decrease (457+/-56 before and 438+/-54 ms after hemodialysis) and the P3 latency habituation during the ERP measurement was also significantly decreased. Patients with higher levels of blood urea nitrogen (BUN), creatinine, and uric acid performed better in ERP measurement than did patients with lower levels. Hemoglobin did not influence ERP latencies and amplitudes. Our data suggest that impaired cognitive processing can be disclosed by ERP even in neurologically asymptomatic chronic renal disease. Removal of uremic toxins by hemodialysis leads to an improvement in cognitive processing.