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Dialysis disequilibrium syndrome

MedGen UID:
588475
•Concept ID:
C0403559
•
Disease or Syndrome
Synonyms: Dialysis disequilibrium; Dialysis Disequilibrium Syndrome; Disequilibrium Syndrome
SNOMED CT: Dialysis disequilibrium syndrome (87235005); Dialysis disequilibrium (87235005)

Definition

A complication occurring during hemodialysis that is thought to be due to a rapid decrease in blood urea nitrogen, and is characterized by an increase in intracranial pressure resulting in nausea, headache, vomiting, restlessness, and/or a decreased level of consciousness. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDialysis disequilibrium syndrome

Professional guidelines

PubMed

Management of dysnatremias with continuous renal replacement therapy.
Yessayan LT, Szamosfalvi B, Rosner MH
Semin Dial 2021 Nov;34(6):472-479. Epub 2021 Jul 3 doi: 10.1111/sdi.12983. PMID: 34218456
Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.
Saha M, Allon M
Clin J Am Soc Nephrol 2017 Feb 7;12(2):357-369. Epub 2016 Nov 9 doi: 10.2215/CJN.05260516. PMID: 27831511Free PMC Article
Superiority of hemofiltration to hemodialysis for treatment of chronic renal failure: comparative studies between hemofiltration and hemodialysis on dialysis disequilibrium syndrome.
Kishimoto T, Yamagami S, Tanaka H, Ohyama T, Yamamoto T, Yamakawa M, Nishino M, Yoshimoto S, Maekawa M
Artif Organs 1980 May;4(2):86-93. doi: 10.1111/j.1525-1594.1980.tb03911.x. PMID: 7396769

Recent clinical studies

Etiology

Acute kidney injury in neurocritical care.
Husain-Syed F, Takeuchi T, Neyra JA, Ramírez-Guerrero G, Rosner MH, Ronco C, Tolwani AJ
Crit Care 2023 Sep 3;27(1):341. doi: 10.1186/s13054-023-04632-1. PMID: 37661277Free PMC Article
Dialysis Disequilibrium Syndrome and Intracranial Pressure Fluctuations in Neurosurgical Patients Undergoing Renal Replacement Therapy: Systematic Review and Pooled Analysis.
Parsons AD, Sanscrainte C, Leone A, Griepp DW, Rahme R
World Neurosurg 2023 Feb;170:2-6. Epub 2022 Dec 6 doi: 10.1016/j.wneu.2022.11.142. PMID: 36494069
Dialysis disequilibrium syndrome (DDS) in pediatric patients on dialysis: systematic review and clinical practice recommendations.
Raina R, Davenport A, Warady B, Vasistha P, Sethi SK, Chakraborty R, Khooblall P, Agarwal N, Vij M, Schaefer F, Malhotra K, Misra M
Pediatr Nephrol 2022 Feb;37(2):263-274. Epub 2021 Oct 5 doi: 10.1007/s00467-021-05242-1. PMID: 34609583
Half the V by 120: A practical approach to the prevention of the dialysis disequilibrium syndrome.
Genena KH, Ahmed S, Szerlip HM, Schwartz JC
Hemodial Int 2021 Oct;25(4):424-432. Epub 2021 Jun 18 doi: 10.1111/hdi.12938. PMID: 34145961
Dialysis disequilibrium syndrome.
Hill MB
Nephrol Nurs J 2001 Jun;28(3):348-9. PMID: 12143458

Diagnosis

Brain Herniation and Intracranial Hypertension.
Tadevosyan A, Kornbluth J
Neurol Clin 2021 May;39(2):293-318. Epub 2021 Mar 31 doi: 10.1016/j.ncl.2021.02.005. PMID: 33896520
Renal Disease and Neurology.
Hocker SE
Continuum (Minneap Minn) 2017 Jun;23(3, Neurology of Systemic Disease):722-743. doi: 10.1212/CON.0000000000000469. PMID: 28570326
Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.
Saha M, Allon M
Clin J Am Soc Nephrol 2017 Feb 7;12(2):357-369. Epub 2016 Nov 9 doi: 10.2215/CJN.05260516. PMID: 27831511Free PMC Article
Nervous system complications in uremia.
Fraser CL, Arieff AI
Ann Intern Med 1988 Jul 15;109(2):143-53. doi: 10.7326/0003-4819-109-2-143. PMID: 2837930
Pathogenesis of dialysis encephalopathy.
Arieff AI, Mahoney CA
Neurobehav Toxicol Teratol 1983 Nov-Dec;5(6):641-4. PMID: 6366603

Prognosis

Symptomatic Hyperglycemia in a Patient with Dialysis Ascites.
Vigil D, Kien C, Gibb J, Glew RH, Tzamaloukas AH
Am J Med Sci 2019 Jun;357(6):512-516. Epub 2019 Feb 27 doi: 10.1016/j.amjms.2019.02.016. PMID: 30975430
Dialysis disequilibrium syndrome: A preventable fatal acute complication.
Mah DY, Yia HJ, Cheong WS
Med J Malaysia 2016 Apr;71(2):91-2. PMID: 27326954
Pseudosubarachnoid hemorrhage: an ominous sign in dialysis disequilibrium syndrome.
Tsai WC, Chen JC, Tsao YT
Am J Emerg Med 2015 Apr;33(4):602.e3-4. Epub 2014 Oct 11 doi: 10.1016/j.ajem.2014.09.030. PMID: 25308826
Rapid unexpected brain herniation in association with renal replacement therapy in acute brain injury: caution in the neurocritical care unit.
Osgood M, Compton R, Carandang R, Hall W, Kershaw G, Muehlschlegel S
Neurocrit Care 2015 Apr;22(2):176-83. doi: 10.1007/s12028-014-0064-y. PMID: 25228117
Hospitalization for initiation of maintenance hemodialysis.
Agraharkar M, Martinez MA, Kuo YF, Ahuja TS
Nephron Clin Pract 2004;97(2):c54-60. doi: 10.1159/000078401. PMID: 15230279

Clinical prediction guides

Prevention of dialysis disequilibrium syndrome in children with advanced uremia with a structured hemodialysis protocol: A quality improvement initiative study.
Sethi SK, Luyckx V, Bunchman T, Nair A, Bansal SB, Pember B, Soni K, Savita, Yadav DK, Sharma V, Alhasan K, Raina R
Hemodial Int 2024 Apr;28(2):216-224. Epub 2024 Mar 20 doi: 10.1111/hdi.13147. PMID: 38504636
Symptomatic Hyperglycemia in a Patient with Dialysis Ascites.
Vigil D, Kien C, Gibb J, Glew RH, Tzamaloukas AH
Am J Med Sci 2019 Jun;357(6):512-516. Epub 2019 Feb 27 doi: 10.1016/j.amjms.2019.02.016. PMID: 30975430
Dialysis disequilibrium syndrome: A preventable fatal acute complication.
Mah DY, Yia HJ, Cheong WS
Med J Malaysia 2016 Apr;71(2):91-2. PMID: 27326954
Hospitalization for initiation of maintenance hemodialysis.
Agraharkar M, Martinez MA, Kuo YF, Ahuja TS
Nephron Clin Pract 2004;97(2):c54-60. doi: 10.1159/000078401. PMID: 15230279
Brain swelling after dialysis: old urea or new osmoles?
Silver SM, Sterns RH, Halperin ML
Am J Kidney Dis 1996 Jul;28(1):1-13. doi: 10.1016/s0272-6386(96)90124-9. PMID: 8712203

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