Dialysis encephalopathy and osteomalacic bone disease
Identifieur interne : 002689 ( Main/Corpus ); précédent : 002688; suivant : 002690Dialysis encephalopathy and osteomalacic bone disease
Auteurs : Jerilynn C. Prior ; E. C. Cameron ; W. J. Knickerbocker ; Vincent P. Sweeney ; O. SuchowerskySource :
- The American Journal of Medicine [ 0002-9343 ] ; 1981.
Abstract
Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.
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DOI: 10.1016/0002-9343(82)90574-5
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Knickerbocker</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Sweeney, Vincent P" sort="Sweeney, Vincent P" uniqKey="Sweeney V" first="Vincent P." last="Sweeney">Vincent P. Sweeney</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Suchowersky, O" sort="Suchowersky, O" uniqKey="Suchowersky O" first="O." last="Suchowersky">O. Suchowersky</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB</idno><date when="1982" year="1982">1982</date><idno type="doi">10.1016/0002-9343(82)90574-5</idno><idno type="url">https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002689</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Dialysis encephalopathy and osteomalacic bone disease</title><author><name sortKey="Prior, Jerilynn C" sort="Prior, Jerilynn C" uniqKey="Prior J" first="Jerilynn C." last="Prior">Jerilynn C. Prior</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Cameron, E C" sort="Cameron, E C" uniqKey="Cameron E" first="E. C." last="Cameron">E. C. Cameron</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Knickerbocker, W J" sort="Knickerbocker, W J" uniqKey="Knickerbocker W" first="W. J." last="Knickerbocker">W. J. Knickerbocker</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Sweeney, Vincent P" sort="Sweeney, Vincent P" uniqKey="Sweeney V" first="Vincent P." last="Sweeney">Vincent P. Sweeney</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author><author><name sortKey="Suchowersky, O" sort="Suchowersky, O" uniqKey="Suchowersky O" first="O." last="Suchowersky">O. Suchowersky</name><affiliation><mods:affiliation>Vancouver, British Columbia, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Medicine</title><title level="j" type="abbrev">AJM</title><idno type="ISSN">0002-9343</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1981">1981</date><biblScope unit="volume">72</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="33">33</biblScope><biblScope unit="page" to="42">42</biblScope></imprint><idno type="ISSN">0002-9343</idno></series><idno type="istex">2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB</idno><idno type="DOI">10.1016/0002-9343(82)90574-5</idno><idno type="PII">0002-9343(82)90574-5</idno><idno type="ArticleID">82905745</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9343</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Jerilynn C. Prior M.D.</name><affiliations><json:string>Vancouver, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>E.C. Cameron M.D.</name><affiliations><json:string>Vancouver, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>W.J. Knickerbocker M.D.</name><affiliations><json:string>Vancouver, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>Vincent P. Sweeney M.D.</name><affiliations><json:string>Vancouver, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>O. Suchowersky M.D.</name><affiliations><json:string>Vancouver, British Columbia, Canada</json:string></affiliations></json:item></author><articleId><json:string>82905745</json:string></articleId><language><json:string>eng</json:string></language><abstract>Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p > 0.005 and p > 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p > 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</abstract><qualityIndicators><score>7.625</score><pdfVersion>1.4</pdfVersion><pdfPageSize>576 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1473</abstractCharCount><pdfWordCount>4581</pdfWordCount><pdfCharCount>31997</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>212</abstractWordCount></qualityIndicators><title>Dialysis encephalopathy and osteomalacic bone disease</title><pii><json:string>0002-9343(82)90574-5</json:string></pii><genre><json:string>research-article</json:string></genre><serie><volume>vol 18</volume><pages><last>171</last><first>162</first></pages><genre></genre><language><json:string>unknown</json:string></language><title>Contributions in nephrotogy</title></serie><host><volume>72</volume><pii><json:string>S0002-9343(00)X0411-1</json:string></pii><pages><last>42</last><first>33</first></pages><issn><json:string>0002-9343</json:string></issn><issue>1</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The American Journal of Medicine</title><publicationDate>1982</publicationDate></host><publicationDate>1981</publicationDate><copyrightDate>1982</copyrightDate><doi><json:string>10.1016/0002-9343(82)90574-5</json:string></doi><id>2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Dialysis encephalopathy and osteomalacic bone disease</title><title level="a" type="sub" xml:lang="en">A case-controlled study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1982</date></publicationStmt><notesStmt><note>This study was supported in part by the British Columbia Medical Services Foundation and was presented in part at the Seventh International Conference on Calcium Regulating Hormones in Estes Park, Colorado on September 9, 1980.</note><note type="content">Section title: Clinical study</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Dialysis encephalopathy and osteomalacic bone disease</title><title level="a" type="sub" xml:lang="en">A case-controlled study</title><author><persName><forename type="first">Jerilynn C.</forename><surname>Prior</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">Requests for reprints should be addressed to Dr. Jerilynn C. Prior, 2775 Heather Street, Vancouver, British Columbia, V5Z 3J5.</note><note type="biography">From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</note><affiliation>Requests for reprints should be addressed to Dr. Jerilynn C. Prior, 2775 Heather Street, Vancouver, British Columbia, V5Z 3J5.</affiliation><affiliation>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</affiliation><affiliation>Vancouver, British Columbia, Canada</affiliation></author><author><persName><forename type="first">E.C.</forename><surname>Cameron</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</note><affiliation>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</affiliation><affiliation>Vancouver, British Columbia, Canada</affiliation></author><author><persName><forename type="first">W.J.</forename><surname>Knickerbocker</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</note><affiliation>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</affiliation><affiliation>Vancouver, British Columbia, Canada</affiliation></author><author><persName><forename type="first">Vincent P.</forename><surname>Sweeney</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</note><affiliation>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</affiliation><affiliation>Vancouver, British Columbia, Canada</affiliation></author><author><persName><forename type="first">O.</forename><surname>Suchowersky</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</note><affiliation>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</affiliation><affiliation>Vancouver, British Columbia, Canada</affiliation></author></analytic><monogr><title level="j">The American Journal of Medicine</title><title level="j" type="abbrev">AJM</title><idno type="pISSN">0002-9343</idno><idno type="PII">S0002-9343(00)X0411-1</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1981"></date><biblScope unit="volume">72</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="33">33</biblScope><biblScope unit="page" to="42">42</biblScope></imprint></monogr><idno type="istex">2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB</idno><idno type="DOI">10.1016/0002-9343(82)90574-5</idno><idno type="PII">0002-9343(82)90574-5</idno><idno type="ArticleID">82905745</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1982</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</p></abstract></profileDesc><revisionDesc><change when="1981-08-17">Registration</change><change when="1981">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJM</jid><aid>82905745</aid><ce:pii>0002-9343(82)90574-5</ce:pii><ce:doi>10.1016/0002-9343(82)90574-5</ce:doi><ce:copyright type="unknown" year="1982"></ce:copyright></item-info><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para>This study was supported in part by the British Columbia Medical Services Foundation and was presented in part at the Seventh International Conference on Calcium Regulating Hormones in Estes Park, Colorado on September 9, 1980.</ce:note-para></ce:article-footnote><ce:dochead><ce:textfn>Clinical study</ce:textfn></ce:dochead><ce:title>Dialysis encephalopathy and osteomalacic bone disease</ce:title><ce:subtitle>A case-controlled study</ce:subtitle><ce:author-group><ce:author><ce:given-name>Jerilynn C.</ce:given-name><ce:surname>Prior</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref><ce:cross-ref refid="FN1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>E.C.</ce:given-name><ce:surname>Cameron</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="FN1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>W.J.</ce:given-name><ce:surname>Knickerbocker</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="FN1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Vincent P.</ce:given-name><ce:surname>Sweeney</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="FN1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>O.</ce:given-name><ce:surname>Suchowersky</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="FN1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:affiliation><ce:textfn>Vancouver, British Columbia, Canada</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Requests for reprints should be addressed to Dr. Jerilynn C. Prior, 2775 Heather Street, Vancouver, British Columbia, V5Z 3J5.</ce:text></ce:correspondence><ce:footnote id="FN1"><ce:label>1</ce:label><ce:note-para>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</ce:note-para></ce:footnote></ce:author-group><ce:date-accepted day="17" month="8" year="1981"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Dialysis encephalopathy and osteomalacic bone disease</title><subTitle>A case-controlled study</subTitle></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Dialysis encephalopathy and osteomalacic bone disease</title><subTitle>A case-controlled study</subTitle></titleInfo><name type="personal"><namePart type="given">Jerilynn C.</namePart><namePart type="family">Prior</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Vancouver, British Columbia, Canada</affiliation><description>Requests for reprints should be addressed to Dr. Jerilynn C. Prior, 2775 Heather Street, Vancouver, British Columbia, V5Z 3J5.</description><description>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.C.</namePart><namePart type="family">Cameron</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Vancouver, British Columbia, Canada</affiliation><description>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">W.J.</namePart><namePart type="family">Knickerbocker</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Vancouver, British Columbia, Canada</affiliation><description>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vincent P.</namePart><namePart type="family">Sweeney</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Vancouver, British Columbia, Canada</affiliation><description>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O.</namePart><namePart type="family">Suchowersky</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Vancouver, British Columbia, Canada</affiliation><description>From the Departments of Medicine, Radiology and Neurology, The University of British Columbia, and the Renal Unit, Vancouver General Hospital, British Columbia.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1981</dateIssued><dateValid encoding="w3cdtf">1981-08-17</dateValid><copyrightDate encoding="w3cdtf">1982</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</abstract><note>This study was supported in part by the British Columbia Medical Services Foundation and was presented in part at the Seventh International Conference on Calcium Regulating Hormones in Estes Park, Colorado on September 9, 1980.</note><note type="content">Section title: Clinical study</note><relatedItem type="host"><titleInfo><title>The American Journal of Medicine</title></titleInfo><titleInfo type="abbreviated"><title>AJM</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">198201</dateIssued></originInfo><identifier type="ISSN">0002-9343</identifier><identifier type="PII">S0002-9343(00)X0411-1</identifier><part><date>198201</date><detail type="volume"><number>72</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue pages"><start>A3</start><end>A24</end></extent><extent unit="issue pages"><start>A41</start></extent><extent unit="issue pages"><start>A44</start><end>A45</end></extent><extent unit="issue pages"><start>A51</start></extent><extent unit="issue pages"><start>A54</start><end>A55</end></extent><extent unit="issue pages"><start>A58</start></extent><extent unit="issue pages"><start>A61</start></extent><extent unit="issue pages"><start>A64</start><end>A65</end></extent><extent unit="issue pages"><start>A68</start></extent><extent unit="issue pages"><start>1</start><end>176</end></extent><extent unit="pages"><start>33</start><end>42</end></extent></part></relatedItem><identifier type="istex">2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB</identifier><identifier type="DOI">10.1016/0002-9343(82)90574-5</identifier><identifier type="PII">0002-9343(82)90574-5</identifier><identifier type="ArticleID">82905745</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/2C1F503CD1BFF8A140556D5C565CF19F7FFACDBB/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><monogr></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Syndrome of dyspraxia and multifocal seizures associated with chronic hemodi-alysis</title><author><persName><surname>Alfrey Ac</surname></persName></author><author><persName><forename type="first">Burks</forename><forename type="middle">J</forename><surname>Jm</surname></persName></author></analytic><monogr><title level="j">Trans Am Sot Artif Intern Organs</title><imprint><biblScope unit="volume">18</biblScope><biblScope unit="page" from="257" to="261"></biblScope><date type="published" 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