Nephrology Book


Dialysis Disequilibrium Syndrome

Aka: Dialysis Disequilibrium Syndrome, Hemodialysis Disequilibrium Syndrome
  1. See Also
    1. Hemodialysis
    2. Dialysis Emergencies
    3. Hypotension in the Dialysis Patient
    4. End Stage Renal Disease
    5. Bloodstream Infections in Hemodialysis
  2. Epidemiology
    1. Rare, but potentially lethal
  3. Pathophysiology: Dialysis complication
    1. Increased Intracranial Pressure
    2. Rapid decrease in Serum Osmolality during Dialysis
  4. Symptoms
    1. Onset within 12 hours of Dialysis
    2. General
      1. Malaise
      2. Nausea or Vomiting
      3. Muscle cramping
    3. Cardiovascular
      1. Hypertension
    4. Neurologic
      1. Headache
      2. Motor Restlessness
      3. Confusion
      4. Altered Level of Consciousness
      5. Seizures
  5. Differential Diagnosis
    1. Malignancy
    2. Ventricular Arrhythmia
    3. Subdural Hematoma
    4. Intracerebral abscess
    5. Meningitis
    6. Sepsis
    7. Hypertensive Encephalopathy
    8. Hyperkalemia
    9. Hypermagnesemia
    10. Hypercalcemia
    11. Hypoglycemia (or Hyperglycemia)
  6. Diagnostics
    1. Electroencephalogram (EEG)
      1. Diffuse metabolic encephalopathy
  7. Imaging
    1. MRI Brain (diffusion weighted)
      1. Osmotic demyelination of pons (and adjacent structures)
  8. Management
    1. Seizure Prophylaxis
      1. Anticonvulsants
    2. Decrease cerebral edema
      1. Mannitol
      2. Hypertonic Saline
  9. Prevention
    1. Decrease initial Dialysis flow rate and duration (especially if high urea concentration)
  10. References
    1. Glauser (2013) Crit Dec Emerg Med 27(10): 2-12
    2. Shaikh (2010) J Emerg Trauma Shock 3(3): 300 [PubMed]

Dialysis disequilibrium syndrome (C0403559)

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グン
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
Derived from the NIH UMLS (Unified Medical Language System)

You are currently viewing the original '\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree