Case Report: Uremic encephalopathy in acute kidney injury caused by abdominal sepsis

Uremic encephalopathy encompasses a wide range of central nervous system disorders resulting from acute or chronic kidney damage. The pathogenesis of this syndrome is multifactorial and includes the accumulation of uremic toxins, hormonal imbalance, electrolyte and acid-base imbalance, blood-brain barrier dysfunction, and systemic inflammation. There are no specific clinical or laboratory markers for uremic encephalopathy, and the diagnosis is often made retrospectively, based on the dynamics of neurological status. The diagnostic process is further complicated by the presence of comorbid and overlapping diseases. Consequently, renal replacement therapy is often initiated at an suboptimal time. Neuroimaging plays a key role in confirming the diagnosis, providing high sensitivity in assessing the nature and extent of brain tissue damage. The "lenticular fork sign" is recognized as the most significant MRI marker and can serve as an early and reliable indicator of uremic encephalopathy. The implementation of an interdisciplinary strategy, including a comprehensive laboratory assessment and timely neuroimaging, allows not only to confirm the pathogenetic mechanisms underlying central nervous system damage, but also to promptly adjust therapeutic treatment. This publication presents a clinical case of uremic encephalopathy resulting from acute kidney injury associated with abdominal sepsis in a 50-year-old patient.