Encefalopatía asociada a trastornos renales en perros y gatos: revisión bibliográfica

Abstract

Renal-associated encephalopathy is an ill-defi ned condition that has been infrequently reported in dogs and cats with renal failure. This category of metabolic encephalopathy encompasses uremic encephalopathy,dialysis disequilibrium syndrome and posttransplantation encephalopathy. Abnormal mentation and seizure activity are typical abnormalities of this disorder. Other clinical signs may include muscle tremors, generalized weakness and irregular respiration. The cause of uremic encephalopathy is presently unknown. Suggested mechanisms include depressed cerebral oxygen consumption, cerebral hypoxia, increased brain calcium levels, uremic toxins (methylguanidine, guanidinosuccinc acid, phenolic acid) and increased blood levels of parathyroid hormone. Diagnosis of uremic encephalopathy is based upon clinical signs of neurologic dysfunction in a patient with renal failure, with no other obvious cause of brain disease. Treatment depends primarily upon management of the underlying kidney disease. Hemodialysis, peritoneal dialysis, and renal transplantation are also available treatment strategies, although limited by its cost. The prognosis is variable and depends mainly on the specifi c renal abnormality. This article reviews the literature of the main advances in the pathophysiology of the all categories of renal-associated encephalopathy, and therapeutic strategies are discussed.