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Fellows’ Forum
Fellows’ Forum in Dialysis
Edited by Mark A. Perazella: Dialysis Disequilibrium Syndrome: A Narrative Review
Author(s) -
Patel Nilang,
Dalal Pranav,
Panesar Mandip
Publication year - 2008
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2008.00474.x
Subject(s) - medicine , hemodialysis , dialysis , vomiting , disequilibrium , nausea , intensive care medicine , narrative review , surgery
Dialysis Disequilibrium Syndrome (DDS) is characterized by neurological symptoms caused by rapid removal of urea during hemodialysis. It develops primarily from an osmotic gradient that develops between the brain and the plasma as a result of rapid hemodialysis. This results in brain edema that manifests as neurological symptoms such as headache, nausea, vomiting, muscle cramps, tremors, disturbed consciousness, and convulsions. In severe cases, patients can die from advanced cerebral edema. Recent advancements in cell biology implicate the role of urea disequilibrium (with a smaller contribution from organic osmolytes) as the pathophysiological mechanism responsible for this syndrome. In this review, we discuss the pathogenesis, clinical features and prevention of DDS.