Dialysis disequilibrium syndrome

What is dialysis disequilibrium syndrome? 

Dialysis disequilibrium syndrome is the name given to the cerebral edema produced by the rapid removal of urea and other osmoles and fluid and electrolyte shifts associated with dialysis.

Dialysis disequilibrium is most likely to occur in patients either during or after their first treatment but can occur at any time in their treatment.

The incidence appears to be decreasing, likely due to the earlier initiation of dialysis in the course of end-stage renal disease.

The symptoms are nonspecific, but they are similar to those of ICH. They include persistent headache and fatigue. The syndrome may also be sufficiently severe to produce seizures, coma, and death.

Due to the nonspecific nature of the symptoms, other causes of increased intracranial pressure must be ruled out.

Recognition of this problem has led to newer protocols using more frequent, but less vigorous, dialysis.

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