PROGRESSION OF CEREBRAL ATROPHY IN PATIENTS ON REGULAR HEMODIALYSIS-TREATMENT - LONG-TERM FOLLOW-UP WITH CEREBRAL COMPUTED-TOMOGRAPHY

Fifteen patients (10 males, 5 females) on regular hemodialysis treatme nt (average age 43.6+/-4.0 years, average time on dialysis 100.7+/-62. 8 months) underwent cerebral computed tomography between 1981 and 1984 . Ten patients showed mild cerebral atrophy (CA) on the basis of corti cal sulci exceeding 3 mm in breadth and an Evans ratio exceeding 0.31, for a total of 14 degrees of CA (mean 0.9+/-1). The same 15 patients underwent a second cerebral computed tomography during 1991/92 (101+/- 23.7 months later). At that time, the patients exhibited a degree of C A of 2.6+/-1.4, for a total of 39 degrees with an overall increase of 25 degrees. Since CA is not detected before the age of 55 years in the normal population, we conclude that the CA in this patient group can only be attributed to uremia-related pathology and that it tends to wo rsen as regular hemodialysis treatment continues. Nevertheless, no evi dent cognitive, affective, or behavioural changes were verified in the se patients. To our knowledge, this is the first presentation of radio logically documented progression of CA in the same patient population over time.