Assessment of Electroencephalographic Changes in Different Stages of Chronic Kidney Disease

Background: Chronic Kidney Disease (CKD) is defined by the Kidney Disease Outcomes Quality Initiative (KDOQI) working group of the National Kidney Foundation (NKF) as evidence of structural or functional kidney abnormalities that persist for at least 3 months, with or without a decreased Glomerular Filtration Rate (GFR). Electroencephalogram (EEG) is useful in assessing patients in uremic encephalopathy and in monitoring their progress. Objective: The aim of the current study was ro evaluate the EEG changes in different stages of CKD. Patients and methods: This cross-sectional study was conducted in the Pediatrics Department at Zagazig University Hospitals on 61 patients with CKD at different stages. All included patients had been subjected to predesigned working sheet. Serum creatinine level, 24-hour urinary protein excretion, estimation of glomerular filtration rate and EEG were done for all patients. GFR was calculated by MDRD formula. Results: Our study showed statistically significant increased asymmetry and dysrhythmia among stages 3 and 4 than stages 1 and 2, while symmetry was statistically significant higher among stages 1 and 2 than stages 3 and 4. There was statistically significant increased low amplitude among stages 3 and 4 than stages 1 and 2, while high amplitude was higher among stages 1 and 2 than stages 3 and 4, with no significant difference between the pre-dialytic stages regarding medium and high amplitudes. There was highly statistically significant difference between the CKD patients with and without neuropathy regarding albumin, creatinine and eGFR where albumin and creatinine was higher among uremic neuropathy patients than non-uremic neuropathy, while eGFR was highly significantly higher among the non-uremic neuropathy than the uremic neuropathy patients. Conclusion: EEG findings which are characteristics of uremic encephalopathy can be present in CKD patients without frank signs of encephalopathy.