Abstract
Renal failure and diabetes can induce cerebral complications, including encephalopathy, for which attentional and cognitive impairment are common symptoms. It is possible that renal failure with comorbid diabetes may induce more severe encephalopathy due to multiple pathogenic mechanisms. This concept was supported by the main findings of this study, which showed that EEG background activity between end-stage renal disease with and without comorbid diabetes was significantly different in relative power of delta in the eyes-open condition in frontoparietal regions; theta in the eyes-closed condition in all regions; beta in the parieto-occipital regions in both eye conditions; the delta/theta ratio in both eye conditions in frontoparietal regions; and the theta/beta ratio in all regions in the eyes-closed condition. These findings may increase awareness of comorbid cerebral complications in clinical practice. Moreover, the delta/theta ratio is recommended as an optimal feature to possibly determine the severity of encephalopathy.
Highlights
End-stage renal disease (ESRD), a failure of regulatory and excretory renal function, has been known to directly cause uremic toxin accumulation, blood-brain barrier damage, and serum electrolyte derangement, among other problems (Chillon et al, 2016; Jabbari and Vaziri, 2018; Hamed, 2019)
(2) EEG background activity of each ESRD-Diabetes mellitus (DM) and ESRD-C patient should have deviated from the mean of normative database due to cerebral complications caused by diabetes or renal failure
The Z-score relative power that showed global differences between ESRD-C and ESRD patients with DM (ESRD-DM) are shown in a topographical map so that the region of significance could be determined (Figures 3–6)
Summary
End-stage renal disease (ESRD), a failure of regulatory and excretory renal function, has been known to directly cause uremic toxin accumulation, blood-brain barrier damage, and serum electrolyte derangement, among other problems (Chillon et al, 2016; Jabbari and Vaziri, 2018; Hamed, 2019). It is possible that renal failure with comorbid diabetes may induce more severe encephalopathy due to multiple pathogenic mechanisms This concept was supported by the main findings of this study, which showed that EEG background activity between end-stage renal disease with and without comorbid diabetes was significantly different in relative power of delta in the eyes-open condition in frontoparietal regions; theta in the eyes-closed condition in all regions; beta in the parieto-occipital regions in both eye conditions; the delta/theta ratio in both eye conditions in frontoparietal regions; and the theta/beta ratio in all regions in the eyes-closed condition. The delta/theta ratio is recommended as an optimal feature to possibly determine the severity of encephalopathy
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