Failure of successful renal transplantation to reverse the dialysis-associated encephalopathy syndrome.

A patient is described who had been on home dialysis for two years before receiving a cadaver kidney transplant. In retrospect, minor speech difficulties were noted two weeks before the transplant. A week after the transplant the characteristic speech, movement and electroencephalographic (EEG) abnormalities of the dialysis encephalopathy syndrome abruptly presented. Relentless neurological deterioration ensued ending in death three months later despite excellent function in the transplant. The significance of this observation is related to current theories of pathogenesis.