Dialysis Disequilibrium Syndrome: Treatment Leading to Fatality

Abstract

Dialysis disequilibrium syndrome (DDS) is a rare disorder caused by rapid removal of blood urea nitrogen (BUN) during dialysis treatment resulting in adjusted concentrations of the osmotic gradients between fluid compartments inside the human body. The consequential osmotic pressure may cause rapid cerebral edema, leading to headaches, dizziness, seizures, and in severe circumstances, death. If dialysis is stopped immediately when symptoms appear, DDS will often be self – limiting, and will not cause permanent damage. The best prevention of the syndrome is through gentle reduction of the urea concentration by slowly introducing the hemodialysis in brief, frequent intervals. Primary treatment once the condition has been diagnosed is stabilization of intracranial pressure through the administration of mannitol.

ABBREVIATIONS: DDS - dialysis disequilibrium syndrome, BUN - blood urea nitrogen, CSF - cerebrospinal fluid.