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Uremic Encephalopathy Treatment & Management

  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
Updated: Jun 05, 2014

Medical Care

No medications are specific to the treatment of encephalopathy.

  • The presence of uremic encephalopathy in a patient with either acute kidney injury or chronic kidney failure is an indication for the initiation of dialytic therapy (ie, hemodialysis, peritoneal dialysis, continuous renal replacement therapy). After beginning dialysis, the patient generally improves clinically, although EEG findings may not improve immediately.
  • In patients with end-stage renal disease (ESRD), EEG abnormalities generally improve after several months but may not completely normalize.
  • Address the following factors when treating uremic encephalopathy, which are also included in the standard care of any patient with ESRD:
    • Adequacy of dialysis
    • Correction of anemia
    • Regulation of calcium and phosphate metabolism


See the list below:

  • Consult a neurologist if symptoms do not improve upon initiation of dialysis therapy.
  • Consult a vascular surgeon for placement of vascular access in patients with ESRD.
  • Refer patients with ESRD to a dietitian familiar with renal diseases.


See the list below:

  • To avoid malnutrition in patients with ESRD, maintain adequate protein intake (1.2 g/kg/d) and initiate dialysis (despite the presence of encephalopathy).


Instruct patients with significant symptoms to continue bed rest.

Contributor Information and Disclosures

James W Lohr, MD Professor, Department of Internal Medicine, Division of Nephrology, Fellowship Program Director, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, Central Society for Clinical and Translational Research

Disclosure: Partner received salary from Alexion for employment.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ajay K Singh, MB, MRCP, MBA Associate Professor of Medicine, Harvard Medical School; Director of Dialysis, Renal Division, Brigham and Women's Hospital; Director, Brigham/Falkner Dialysis Unit, Faulkner Hospital

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.


Donald A Feinfeld, MD, FACP, FASN Consulting Staff, Division of Nephrology and Hypertension, Beth Israel Medical Center

Disclosure: Nothing to disclose.

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