Silent neurological lesions detected by magnetic resonance imaging: Relationship to hyperparathyroidism among end-stage renal disease young patients on haemodialysis.

Abstract

End-stage renal disease (ESRD) patients on haemodialysis (HD) suffer from several peripheral and central neurological complications. They are at high risk for developing silent neurological lesions (SNL) that may be detected accidentally by magnetic resonance imaging (MRI). Many factors are implicated in the development of neurological deficits in ESRD patients on HD. Evaluation of SNL in young ESRD patients by using MRI and assessing its correlation with hyperparathyroidism. The study involved 48 young ESRD patients (mean age of 19.6±6years) with HD and do not have any apparent abnormalities in the neurological examination. Laboratory investigations and conventional brain MRI were done on all. 79.2% have SBI and 45.8% have white matter lesions. Regression analysis revealed that calcium level and duration of dialysis were independent predictor factors for the presence of silent brain MRI lesions (P=.034 & 0.045 respectively). ROC curve showed that parathyroid hormone (PTH) level >585pg/mL, duration of dialysis >2years, and calcium level >7.5mg/dL predicted the presence of SNL. The duration of HD and hyperparathyroidism (HPT) were independent predictors for the presence of SNL. MRI brain is considered as a mandatory affordable tool for HD patients >2years and has HPT for early detection of SNL to help early intervention and avoid neurological complications and disabilities.