Treatment of uremic encephalopathy

Patients with uremic encephalopathy should pay attention to scientific methods and techniques in treatment. Common treatments include dialysis, kidney transplantation, and supportive treatment in life. They should correct malnutrition and irreversible factors, and cooperate with Chinese medicine conditioning.

1. Treatment methods

1. Dialysis treatment; adequate dialysis can reduce the occurrence of uremic encephalopathy.

2. Kidney transplantation treatment: can fundamentally treat uremia.

3. Supportive treatment: Correcting malnutrition and other reversible factors (such as electrolyte imbalance, dehydration, acidosis, hypertension, etc.) can reduce the occurrence of uremic encephalopathy.

4. Reduce the chance of drug damage.

5. Symptomatic treatment: Sedatives can be given in case of convulsions and epileptic seizures. For those with delirium or excitement and agitation, 10 to 20 mg of diazepam can be injected intravenously, or paracetamol, chlorpromazine or perphenazine can be used. For patients with epilepsy, 1000 mg of phenytoin sodium may be injected intravenously at a rate not exceeding 50 mg per minute or 100-150 mg of diazepam may be slowly dripped intravenously for 24 hours under blood pressure and ECG monitoring. If necessary, add lidocaine, first give 1 mg/kg intravenously at a time. If it is ineffective, give another 0.5 mg/kg within 2 minutes. After the convulsion stops, give 30 μg/kg per minute as a maintenance dose. Those with water intoxication should be dehydrated or dialyzed. Those with high neuromuscular excitability can be given an intravenous injection of 20 mL of 10% calcium gluconate. If there is hypertensive encephalopathy, it should be treated as hypertensive encephalopathy.

2. Traditional Chinese Medicine Treatment

Through the above comparison of the treatment methods of uremic encephalopathy, nephrologists recommend that traditional Chinese medicine be used as the preferred treatment. Traditional Chinese medicine believes that uremic encephalopathy is a critical syndrome of heart obstruction, and its occurrence mechanism is mainly due to turbid toxins obscuring the pericardium.

Patients with uremic encephalopathy may suffer from mania, schizophrenia, or convulsion and coma in the later stages. Uremic encephalopathy is an acute and severe disease. If it is not treated correctly and effectively, the prognosis is extremely poor. This is the result of the accumulation of urea toxins in the blood, cerebral circulation and metabolic disorders, water and electrolyte imbalance and metabolic acidosis, which change the membrane permeability of nerve cells and glial cells and cause uremic cerebral edema. Changes in the EEG are often parallel to the clinical symptoms. Mild cases show a normal low-potential type, a decrease in а waves and a tendency to slow waves, followed by the appearance of diffuse slow waves and often paroxysmal slow waves, indicating diffuse damage to the central nervous system function.