ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Dialysis disequilibrium syndrome
Other Resources UpToDate PubMed

Dialysis disequilibrium syndrome

Contributors: Andrea Wasilewski MD, Catherine Moore MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Dialysis disequilibrium syndrome (DDS) is a condition that arises following hemodialysis, typically in patients undergoing hemodialysis for the first time or in patients with risk factors including elevated blood urea nitrogen prior to hemodialysis, chronic kidney disease, severe metabolic acidosis, and other disorders that cause cerebral edema or increase the permeability of the blood-brain barrier. It is more common in older adults and children.

DDS occurs due to osmotic shifts and rapid lowering of urea and plasma osmolality, resulting in the development of cerebral edema following hemodialysis. Patients present with symptoms including headache, nausea, vomiting, muscle cramps, tremor, confusion, and convulsions. Symptoms typically present during or immediately following hemodialysis or early in the course of continuous renal replacement therapy. DDS has not been described with continuous peritoneal dialysis.

Treatment involves slowing the blood flow rate of dialysis or cessation of dialysis in severe cases.

Codes

ICD10CM:
E87.8 – Other disorders of electrolyte and fluid balance, not elsewhere classified

SNOMEDCT:
87235005 – Dialysis disequilibrium syndrome

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed: 02/11/2019
Last Updated: 02/11/2019
Copyright © 2020 VisualDx®. All rights reserved.
Dialysis disequilibrium syndrome
Print  
Dialysis disequilibrium syndrome : Blurred vision, Dizziness, Seizures, Headache, Asterixis, Muscle cramp, BUN elevated, Confusion
Copyright © 2020 VisualDx®. All rights reserved.