요독성 뇌증에서 가역적인 기저핵 병변

• Published in: Kidney research and clinical practice Vol. 22; no. 5; pp. 618 - 621
• Main Authors: 장민화, Jang Min Hwa, 최혁준, Choe Hyeog Jun, 조지형, Jo Ji Hyeong, 권혁만, Kwon Hyeog Man, 김찬덕, Kim Chan Deog, 박선희, Park Seon Hui, 조동규, Jo Dong Gyu, 김용림, Kim Yong Lim
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 30.09.2003
• Subjects: Adequacy; MRI; Uremic encephalopathy
• ISSN: 2211-9132

Uremic encephalopathy is a well-known complication in uremia and may result from changes of cerebral metabolism due to uremic toxins. Specific morphological changes have not been observed and pathogenesis is still unclear. We experienced a case with nremic encephalopathy in whom reversible abnormalities were observed on brain magnetic resonance image (MRI). A 61-year-old man with chronic renal failure due to diabetic nephropathy started automated peritoneal dialysis (APD) one year ago(therapy time : 10 hours, number of cycles : 5, fill volume per cycle : 2 L). He developed gait disturbance and dysarthria after he dwelled icodextrin contained 2 L dialysate over night instead of APD. In that time, his weekly Kt/V and creatinine clearance were 1.5 nad 87.5 L/week/1.73 ㎡, respectively. On brain MRI, low signal in T1 image and high signal in T2 image were seen in putamen and globus pallidus bilaterally. Insufficient peritoneal dialysis adequacy was documented, and the patient was switched from APD to continuous ambulatory peritoneal dialysis (CAPD). After than, his symptom gradually improved. On follow-up MRI 2 months later, previous lesion has disappeared. (Korean J Nephrol 2003;22(5):618-621)