Do you experience symptoms like headaches, nausea, and restlessness during or after dialysis treatment? If yes, you may have developed a rare complication that occurs in people who go through dialysis called dialysis disequilibrium syndrome. It causes many symptoms due to physiological changes like cerebral edema and increased intracranial pressure. Its symptoms can range from mild to severe which can lead to coma or even death. Learn the preventive strategies to manage dialysis disequilibrium syndrome in this article. If you want to know more about urological health, visit us at Doral Health and Wellness Urology Center and consult with the best nephrologists and urologists in East New York.
Prevention tips for patients
If you are struggling with dialysis disequilibrium syndrome, here are some preventive measures you can ask your medical team to take to reduce the risk:
• Slowly start dialysis by limiting the first session to around 2 hours with slow blood flow rates.
• Repeat the session for 3 to 4 days daily, it may not be the usual frequency in the long run because more frequency can make sessions gentle for your body to handle.
• Infusion of dialysis with mannitol (a diuretic) or saline before symptoms appear to prevent fluid buildup in the brain.
• Increase the level of dialysate sodium in your treatment because it helps to balance out the fluid levels in the body.
• Decreasing the rate of urea clearance can prevent water from building up in the brain.
Besides these, you need to be:
• Eating properly to improve your dialysis performance and overall health. During dialysis, you should be careful with the intake of fluids, protein, sodium, potassium, and phosphorus. You can use the help of a dietitian to create a meal plan based on health and medical requirements.
• Following the instructions of your healthcare team properly to take medicine on time to manage your condition.
• Getting help from your healthcare team with your concerns and learning what options are available to deal with them.
Tips for caregivers
Here are some tips for caregivers to take care of DDS patients, including:
1. Monitor the symptoms:
DDS symptoms usually occur together or soon after dialysis is initiated or completed, however, they can occur even 24 hours later. The main symptoms of dialysis disequilibrium syndrome are – headache, blurred vision, dizziness, nausea, and vomiting, asterixis, and LOC changes. The patient may also feel restless, confused, somnolent, or even manic. In severe cases, it can result in seizure, coma, and death. While it doesn’t cause any neurological symptoms, it is believed that DDS may cause muscle cramping at the end of dialysis treatment. As a caregiver, you need to monitor these symptoms.
2. Know how to assess the patient:
To assess the patient, you need to keep a close eye on the patient’s neurological status. Take any complaints seriously if signs like headache, blurred vision, nausea, and dizziness start to appear. If your patient becomes more agitated, more somnolent, or confused, all these are the signs of DDS that might occur. You should keep a set of VS before starting dialysis to note the patient’s blood pressure. Keep in mind that a patient who experiences a hypertensive crisis is at higher risk for DDS.
3. Preventive strategies to protect the patient:
To protect the patient, you need to prevent DDS from occurring. To do that, you can use these preventive strategies, including:
• Slow the dialysate blood flow, this decreases the time that urea is removed from the bloodstream.
• Reduce the duration of the hemodialysis session.
• Mitigate osmotic shifts through a process called sodium modeling. This technique uses sodium content of the dialysate changes throughout the dialysis treatment to slow the removal of sodium from the bloodstream. This can either be done through a machine with a special sodium modeling feature or by changing the dialysate sodium solution.
• Reduce the concentration of sodium bicarbonate in patients who retain carbon dioxide, such as those with COPD because CO2 can serve as a cerebral vasodilator that leads to increases in intracranial pressure.
• Give hypertonic saline or mannitol (an osmotic diuretic) or both. These fluids cause fluid buildup in the brain cells to leave and lower cerebral edema. Switch the patient to a slow, gentle continuous mode of renal replacement therapy.
• You can hyperventilate the patient to remove excess CO2 and reduce intracranial pressure. Keep in mind that it’s an option for mechanically ventilated patients. Manage symptoms such as nausea and restlessness with appropriate pharmacologic medications such as ondansetron and benzodiazepines.
Managing dialysis disequilibrium syndrome is essential for a patient who is undergoing dialysis treatment. It is a severe condition that causes symptoms like headaches, nausea, or restlessness, and in severe cases, can lead to seizures, coma, and even death. So, you or your caregivers should follow the above-mentioned prevention measures to manage DDS and live a healthy life.
Need help with DDS, visit our urology clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!
At Doral Health and Wellness Urology Center, our team of urologists will work with you in managing your disease and your quality of life. We also offer services, such as renal and bladder ultrasound. 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://www.urologistbrooklyn.com/.