Dialysis disequilibrium syndrome

Background

• Clinical syndrome occurring at end of dialysis
  • Occurs most commonly during initial dialysis or during hypercatabolic states
  • Large solute clearances -> cerebral edema

Clinical Features

• nausea and vomiting, HTN; can progress to seizure, coma, death

Differential Diagnosis

Dialysis Complications

• Dialysis-associated hypotension
• Dialysis disequilibrium syndrome
• Air embolism
• Missed dialysis (pulmonary edema)

Workup

• Diagnosis of exclusion (r/o SDH, CVA)

Management

• Treat with mannitol

See Also

• Dialysis complications