Posterior reversible encephalopathy syndrome: a noteworthy syndrome in end-stage renal disease patients.
BACKGROUND
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiologic entity characterized by headache, visual disturbances, seizures, and the presence of edema on MRI scan, predominantly in the posterior white matter. Regarding end-stage renal disease (ESRD) and PRES, only a few cases of children on peritoneal dialysis (PD) and adults on hemodialysis have been described in the literature.


METHODS
We report 4 cases of adult patients on PD who presented with PRES, all of which were due to hypertension and inadequate management of fluid balance. The patients expressed typical PRES symptoms such as headache, visual disorders, and tonic/clonic seizures. The patients recovered completely and the MRI lesions disappeared after strict control of volume status.


CONCLUSIONS
Nephrologists should be aware of the syndrome, especially when they manage hypertensive ESRD patients not compliant with the fluid and diet restrictions. MRI scan is the only diagnostic tool for defining the syndrome. Early diagnosis is important, since complete remission is achieved after appropriate treatment.
Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
Eleni
E
Ermeidi
Olga
O
Balafa
Giorgos
G
Spanos
Anastasia
A
Zikou
Maria
M
Argyropoulou
Kostas C
KC
Siamopoulos
D000328:Adult; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis / Q000209:etiology*