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Use of a polysulfone hemodialysis membrane may prevent recurrent posterior reversible encephalopathy syndrome in a patient undergoing hemodialysis

  • Nephrology - Case Report
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Abstract

A 71-year-old woman underwent hemodialysis (HD) treatment for chronic kidney disease. During HD, she developed headache, abnormalities in visual perception, and generalized convulsion. Brain magnetic resonance imaging (MRI) showed T2-hyperintensity lesions in the posterior lobe, and an electroencephalogram showed slow waves in all areas. Twenty days later, the T2-hyperintensity lesions had vanished. Furthermore, perfusion computed tomography (CT) and single-photon emission CT with N-isopropyl[123I]-p-iodoamphetamine (IMP-SPECT) showed no significant abnormalities. The patient was diagnosed with posterior reversible encephalopathy syndrome (PRES) because she displayed typical clinical symptoms and MRI findings. Although several antihypertensive and antiseizure medications were administered, the patient experienced recurrent PRES. Therefore, we used a polysulfone dialyzer to reduce the oxidative stress and inflammation while preserving vascular endothelial function. After use of a polysulfone dialyzer membrane, the patient had no PRES episodes during the clinical course. This is the first study to demonstrate that use of a polysulfone dialyzer membrane instead of a cellulose membrane may prevent recurrent PRES.

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Acknowledgments

Preparation of this publication was supported by grants to A.M. from grant-in-aid for Scientific Research (24890148) from Japan Society for the Promotion of Science, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Takeda Science Foundation, Japanese Association of Dialysis Physicians (JADP Grant 2012-03), and The Kidney Foundation, Japan (JKF13-1).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nephrology, Graduate School of Medicine, Institute of Health Biosciences, University of Tokushima, Tokushima, 770-8503, Japan

    Akira Mima & Taichi Murakami

  2. Shizuoka City Hospital, Shizuoka, Japan

    Akira Mima, Takeshi Matsubara, Shuichiro Endo, Taichi Murakami & Yasuki Hashimoto

  3. Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan

    Takeshi Matsubara & Shuichiro Endo

  4. Hashimoto Medical Clinic, Aichi, Japan

    Yasuki Hashimoto

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  1. Akira Mima
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  2. Takeshi Matsubara
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  3. Shuichiro Endo
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  4. Taichi Murakami
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  5. Yasuki Hashimoto
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Correspondence to Akira Mima.

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Parts of this manuscript were prepared for presentation at a clinical case report conference.

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Mima, A., Matsubara, T., Endo, S. et al. Use of a polysulfone hemodialysis membrane may prevent recurrent posterior reversible encephalopathy syndrome in a patient undergoing hemodialysis. Int Urol Nephrol 46, 255–260 (2014). https://doi.org/10.1007/s11255-013-0434-y

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  • DOI: https://doi.org/10.1007/s11255-013-0434-y

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