II. Epidemiology

  1. Rare, but potentially lethal

III. Pathophysiology: Dialysis complication

IV. 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

VI. Diagnostics

  1. Electroencephalogram (EEG)
    1. Diffuse metabolic encephalopathy

VII. Imaging

  1. MRI Brain (diffusion weighted)
    1. Osmotic demyelination of pons (and adjacent structures)

VIII. Management

  1. Seizure Prophylaxis
    1. Anticonvulsants
  2. Decrease cerebral edema
    1. Mannitol
    2. Hypertonic Saline

IX. Prevention

  1. Decrease initial Dialysis flow rate and duration (especially if high urea concentration)

X. References

  1. Glauser (2013) Crit Dec Emerg Med 27(10): 2-12
  2. Shaikh (2010) J Emerg Trauma Shock 3(3): 300 [PubMed]

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Related Studies

Ontology: 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