Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p less than 0.005 and p less than 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of te patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p less than 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.
dialysis encephalopathy osteomalacia bone disease association, Prior Cameron hemodialysis encephalopathy rib fractures, long-term hemodialysis bone disease case-controlled study, dialysis encephalopathy fractures osteomalacia etiology, hemodialysis osteomalacia bone biopsy aluminum toxicity, dialysis patients rib fractures hyperparathyroidism comparison, Prior JC dialysis bone disease 1982, chronic kidney disease bone mineral metabolism complications, hemodialysis encephalopathy multifactorial etiology older patients, aluminum phosphate binders osteomalacia dialysis patients
PMID 7036724 7036724 DOI 10.1016/0002-9343(82)90574-5 10.1016/0002-9343(82)90574-5
Cite this article
J C Prior, E C Cameron, W J Knickerbocker, V P Sweeney, & O Suchowersky (1982). Dialysis encephalopathy and osteomalacic bone disease: a case-controlled study. The American journal of medicine, 72(1), 33-42. https://doi.org/10.1016/0002-9343(82)90574-5
J C Prior, E C Cameron, W J Knickerbocker, V P Sweeney, O Suchowersky. Dialysis encephalopathy and osteomalacic bone disease: a case-controlled study. Am J Med. 1982;72(1):33-42. doi:10.1016/0002-9343(82)90574-5
J C Prior, et al. "Dialysis encephalopathy and osteomalacic bone disease: a case-controlled study." The American journal of medicine, vol. 72, no. 1, 1982, pp. 33-42.
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