[Two forerunners of the encephalopathy of hemodialysed patients : osteomalacic osteodystrophy and electroencephalographic alterations. Influence of the aluminium concentration in the dialysis fluid (author's transl)].

In a hemodialysis center where the dialysate fluid is rich in aluminium (200 microgram/l), 19 out of 23 patients presented an osteopathy which was severe in most cases. It was also noted that 16 patients showed encephalographic alterations occurring early on, revealed by repeated recordings, and classified in three stages according to severity : the most serious stage presents as paroxysmal bursts of high voltage waves and precedes the myoclonic encephalopathy of dialysed patients. Ten patients showed this complication, and 4 of them died of it. These findings are confronted with the minimal bone and brain alterations of 24 patients undergoing dialysis in another center where the treatment is identical with the exception of the low aluminium content of the dialysate fluid (25 microgram/l).