The effect of low aluminum water and desferrioxamine on the outcome of dialysis encephalopathy.

Five patients with dialysis encephalopathy were transferred to deionized water; all died after a variable period, 4 of progressive dementia. Six other patients with encephalopathy were started either on deionized or reverse osmosis water as well as desferrioxamine on dialysis. Serial EEG's were performed in this group. In 2 patients the EEG's showed rapid and sustained improvement after the institution of desferrioxamine, whereas there had been no EEG change after 15 and 32 months of reverse osmosis water. In 2 patients there was similar clinical and EEG improvement, related to water change and the institution of desferrioxamine. Two patients died of progressive dementia in spite of both water change and desferrioxamine. Thus, while not a panacea, desferrioxamine has a definitive therapeutic effect on the clinical and EEG manifestations of dialysis encephalopathy, when used in conjunction with deionized or reverse osmosis water.