Encephalopathy in children with chronic renal failure.

Progressive encephalopathy with characteristic clinical features and electroencephalographic findings has been reported many times in adult patients treated with maintenance hemodialysis. Two children with chronic renal failure developed a similar encephalopathy prior to their second birthdays and before the initiation of dialysis. Both children required parathyroidectomy for control of severe hyperparathyroidism with persistent hypercalcemia. Slight improvement followed this procedure in one patient. Selected biochemical abnormalities in serum and in brain tissue specimens were compared to those of neurologically unaffected children. Results of thes studies suggest that a direct toxic effect of either aluminum or calcium on the brain does not play an etiologic role in this disorder.