The Japanese Journal of Clinical Dialysis Vol.29 No.10(2-5)

Theme Disorder of central nerve system in dialysis patients
Title Central nervous system complications associated with deficiencies of trace elements and vitamins in chronic dialysis patients
Publish Date 2013/09
Author Takayuki Tsuji 1st Department of Medicine, Hamamatsu University School of Medicine
Author Kazuto Kitajima 1st Department of Medicine, Hamamatsu University School of Medicine
Author Akihiko Kato Division of Blood Purification, Hamamatsu University School of Medicine, University Hospital
[ Summary ] Uremic toxins, chronic inflammation and hormones (e.g. leptin and ghrelin) play roles in anorexia for chronic dialysis patients. Furthermore, restrictions of dietary intake and removal through dialysis membranes contribute to deficiencies of trace elements and vitamins. Vitamin B1 (thiamine) deficiency, leading to severe central nervous system involvement, called Wernicke's encephalopathy, is the most notable deficiency observed in dialysis patients. High doses of thiamine should be administered quickly, if suspicious symptoms such as disturbances of conscious, double vision or gait disorders are observed. This should be done even without typical MRI findings, or evidence of low vitamin B1 blood levels.
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