Q: My father has diabetes and high blood pressure. He also has a kidney failure problem. His nephrologist has given him Humolog injection but his blood sugar levels are till on the higher side. He underwent dialysis for 2 days. His mind is disoriented and he does not respond to anything. He has to undergo dialysis again. Should we go for an MRI or CT scan?

A:It is not possible to comment on any underlying cause and any relationship between your father's dialysis treatment to his poor mental status based on limited information you provided. However, patients with End Stage Renal Disease (ESRD), like in this case, are prone to variable neurological symptoms. These symptoms arise primarily from the effect of excessive uremic toxin waste products on the brain cells, which otherwise would have been filtered by the normal kidneys. Symptoms may include nausea, vomiting, altered consciousness or even abnormal movements or rarely seizure attack. Occasionally these symptoms may arise in patients already on dialysis but are not receiving adequate dosage of dialysis treatment. Rarely, above mentioned symptoms can occur after first dialysis treatment in a patient who is severely uremic. Your fathers neurological status needs to be evaluated by a neurologist.