ERYTHROPOIETIN AND VISUAL HALLUCINATIONS IN PATIENTS ON DIALYSIS

The authors encountered five patients who first had visual hallucinati ons while taking erythropoietin. Since this association had not previo usly been reported, the authors studied a convenience sample of dialys is patients at two institutions to determine the incidence of visual h allucinations in patients on erythropoietin and possible associated ri sk factors. Eleven percent of the patients had visual hallucinations a t one institution with no other factor than erythropoietin as a probab le cause and 2% at the other Significant risk factors for hallucinatio ns included diabetic retinopathy or cataracts (chi(2) = 4.59, df = 1, P = 0.032) and older age (t = 2.24, df = 123, P = 0.27). A multivariat e analysis comparing visual hallucinations, eye pathology and age show ed that eye pathology was close to the trend level of significance but that age maintained significance as a risk factor. The visual halluci nations occurred in response to the administration of erythropoietin a nd appeared to vary in relation to dose. Similarities between the synd rome of visual hallucinations in dialysis patients taking erythropoiet in and the Charles Bonnet syndrome are discussed.