Uremic brain study

The recent use of advanced neuroimaging techniques has led to substantial in vivo study of uremic brain in humans (Arieff et al., 1994). Acute and subacute movement disorders have been observed in patients with ESRD. These have been associated with bilateral basal gangUa and internal capsule lesions (Wang et al., 2004). Cerebral atrophy has been observed in chronic hemodialysis patients, and it tends to worsen as dialysis therapy continues (Savazzi, 1988 Savazzi et al., 1995). Cerebral atrophy had previously been thought to be associated with dialysis donentia, but this is apparently not the case (Mahurkar et al., 1978). ESRD has also been reported to lead to deterioration of vision. Some cases are associated with uremic pseudotumor cerebri, and in these cases, surgical optic nerve fenestration may improve visual loss (Guy et al., 1990 Korzets et al., 1998). 

Arieff AI, Guisado R Massry SG. (1975). Uremic encephalopathy Studies on biochemical alterations in the brain. Kidney Int 7, S194-S200. 

In general then, studies of brain tissue from both intact animal models of uremia and humans with renal lailure have revealed many different biochemical abnormalities associated with the uranic state. However, such investigations have not as yet revealed much about the fundamental mechanisms that might induce such abnormalities. Such studies probably will have to be done in isolated cell systems or subcellular systems from the brain. These systems have the advantage of permitting one to study isolated manifestations of the uremic state while removing the numerous potential confounding influences present in an in vivo model. 

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