Dialysis disequilibrium syndrome (DDS) is a condition that can occur during or after your hemodialysis, which is  a medical procedure used to treat kidney failure. DDS is characterized by neurological symptoms that occurs due to the rapid shift of fluids and solutes in your brain during dialysis.

Doral Health and Wellness provides an in-center dialysis services, managed by our highly trained medical team. To know more about dialysis disequilibrium syndrome, you can consult with the best nephrologists and urologists of Doral Health and Wellness in East New York.

Causes

Here are some key factors contributing to the development of DDS:

  • Urea removal — Hemodialysis is designed to remove waste products, including urea, from your blood. Rapid removal of urea can lead to a higher concentration gradient between your blood and your brain, causing water to move into brain cells.
  • Osmotic gradient — The shift in solute concentration creates an osmotic gradient, leading to water movement into your brain cells to balance the concentration. This influx of water can cause your brain to swell.
  • New or infrequent dialysis patients — DDS is more commonly observed in people who are new to dialysis or those who have had a prolonged period without dialysis. If you are a patient who have just started dialysis or have not been on a regular dialysis schedule, you may be more susceptible to DDS.
  • Neurological impairment — If you have a pre-existing neurological impairment, such as severe uremic encephalopathy, you are at higher risk. The compromised ability of your brain to handle fluid shifts contributes to the syndrome.
  • Imbalances in fluid and electrolytes — If you have a significant imbalances of fluid and electrolytes, particularly with rapid corrections of hyponatremia (low sodium levels), you are more prone to DDS.
  • High urea levels — If you have a very high initial blood urea levels, you may be more prone to DDS. The greater the difference in urea concentration between your blood and brain, the higher the risk.
  • Rate and duration of dialysis — The speed at which dialysis is performed and the duration of the session can influence your risk of DDS. Gradual initiation of dialysis and careful monitoring can help lessen the risk.

It is important for medical providers to be aware of these risk factors and tailor the dialysis prescription to each patient’s specific needs, especially in the early stages of dialysis or when there are significant changes in the treatment plan. Regular monitoring and adjustments can help prevent or minimize the occurrence of DDS.

Symptoms

Common symptoms of DDS include:

  • Headache — If you experienced severe headache, often described as throbbing or pounding.
  • Nausea and vomiting — Feelings of nausea and the urge to vomit are common symptoms of DDS.
  • Restlessness — If you have become agitated, restless, or find it difficult to sit still during or after dialysis.
  • Confusion — DDS can cause confusion and disorientation, making it challenging for you to think clearly or focus.
  • Seizures — In severe cases, you may experience seizures, which are abnormal electrical activities in your brain.
  • Increased intracranial pressure — DDS can lead to an increase in pressure within the skull, contributing to symptoms like headache and neurological disturbances.
  • Coma — In extreme cases, if DDS is not recognized and managed promptly, it can lead to a state of unconsciousness or coma.

It is important to note that the severity of symptoms can vary, and not all patients will experience all of these symptoms. Additionally, the onset of symptoms can occur during dialysis or in the hours following a dialysis session. If you are undergoing hemodialysis  and you have experienced any of these symptoms, notify your medical providers immediately. Treatment involves stopping or slowing down the dialysis session, providing supportive care, and addressing any imbalances in your fluid and electrolyte levels. Monitoring and adjustments to the dialysis plan can also help prevent or minimize the risk of DDS.

If you have symptoms of having kidney problems, talk to your doctor so you can devise a proper treatment plan for your condition. Never take any symptoms of kidney problems for granted. It is better to have it checked early on, before it progresses. At Doral Health and Wellness Urology Center, our team of urologist and nephrologist will work with you in managing your disease and your quality of life. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690. You can also visit our website at https://doralhw.org/department/urology/.