Xiaoxia Chen,1,* Yafeng Zhang,2,* Yue Zhou1 

1Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, People’s Republic of China; 2Department of Public Health, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212003, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yue Zhou, Department of Nephrology, Nanjing First Hospital, No. 68 Changle Road, Nanjing, Jiangsu, 210006, People’s Republic of China, Tel +86-15380998793, Email zy09269@163.com; 56005460@qq.com

Background: Chorea is rare in maintenance dialysis patients but seriously affects the quality of life, and there are few previous reports of this condition. We report two patients undergoing regular hemodialysis for end-stage renal disease, both of whom presented with progressively intensified involuntary limb movements, but originating from different etiologies.
Case Presentation: We report two patients undergoing regular hemodialysis for end-stage renal disease who presented with progressively intensified involuntary limb movements. Treatment with sedatives alone proved ineffective in both cases. Through differential diagnosis, one patient was diagnosed with diabetic striatopathy and managed with intensive glycemic control, while the other was found to have uremic metabolic encephalopathy and treated with a combination of hemodialysis and hemoperfusion. Subsequently the patients’ symptoms improved significantly.
Conclusion: Choreiform movements in hemodialysis patients arise from a variety of etiologies. These two cases suggested the susceptibility to the onset of chorea in the early stage of maintenance hemodialysis.

Keywords: hemodialysis, chorea, case report, end-stage renal disease