UMEM Educational Pearls

Category: Neurology

Title: Uremic Encephalopathy

Keywords: encephalopathy, neurological, mental status abnormality (PubMed Search)

Posted: 1/17/2008 by Aisha Liferidge, MD (Updated: 7/14/2024)
Click here to contact Aisha Liferidge, MD

  • Neurologic manifestations are often the first, yet most insidious, signs of uremia (i.e. electrolyte abnormalities due to renal insufficiency).
  • Signs and symptoms of uremic encephalopathy range from normal to comatose.  Some specific examples include dysarthria, pruritus, restless legs, mental status abnormality, myoclonic jerks, tetany, seizure, confusion, asterixis.
  • Elevated PTH and calcium levels have been shown to particularly correlate with uremic encephalopathy.
  • Elevated BUN levels tend to correlate with the degree of decreased level of consciousness.
  • Ammonia levels are not typically elevated with uremic encephalopathy unless there is simultaneous liver disease.
  • The treatment is dialysis.