II. Epidemiology
- Rare, but potentially lethal
III. Pathophysiology: Dialysis complication
- Increased Intracranial Pressure
- Rapid decrease in Serum Osmolality during Dialysis
IV. Symptoms
- Onset within 12 hours of Dialysis
- General
- Cardiovascular
- Neurologic
- Headache
- Motor Restlessness
- Confusion
- Altered Level of Consciousness
- Seizures
V. Differential Diagnosis
- Malignancy
- Ventricular Arrhythmia
- Subdural Hematoma
- Intracerebral abscess
- Meningitis
- Sepsis
- Hypertensive Encephalopathy
- Hyperkalemia
- Hypermagnesemia
- Hypercalcemia
- Hypoglycemia (or Hyperglycemia)
VI. Diagnostics
-
Electroencephalogram (EEG)
- Diffuse metabolic encephalopathy
VII. Imaging
-
MRI Brain (diffusion weighted)
- Osmotic demyelination of pons (and adjacent structures)
VIII. Management
-
Seizure Prophylaxis
- Anticonvulsants
- Decrease cerebral edema
IX. Prevention
- Decrease initial Dialysis flow rate and duration (especially if high urea concentration)
X. References
- Glauser (2013) Crit Dec Emerg Med 27(10): 2-12
- Shaikh (2010) J Emerg Trauma Shock 3(3): 300 [PubMed]
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Related Studies
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 87235005 |
| Italian | Sindrome da squilibrio dialitico |
| Japanese | 透析不均衡症候群, ﾄｳｾｷﾌｷﾝｺｳｼｮｳｺｳｸﾞﾝ |
| Czech | Disekvilibrační syndrom po dialýze |
| Hungarian | Dialízis disequilibrium szindróma |
| English | Dialysis disequilibrium syndrome, Dialysis disequilibrium, Dialysis disequilibrium syndrome (disorder) |
| Spanish | síndrome de desequilibrio dialítico (trastorno), síndrome de desequilibrio dialítico, Síndrome de desequilibrio dialítico |
| Portuguese | Síndroma de desequilíbrio de diálise |
| Dutch | dialyse disequilibrium syndroom |
| French | Syndrome de déséquilibre dialytique |
| German | Dysaequilibrium-Syndrom unter Dialyse |
