In-Depth Guide to Dialysis Disequilibrium Syndrome: Risk Factors and Treatment Options

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.

Risk Factors

Dialysis equilibrium syndrome is a rare but serious complication associated with hemodialysis. Risk factors include:

  • High Urea Reduction Ratio (URR) — The rapid removal of urea during dialysis may contribute to these syndrome.
  • Low Pre-dialysis BUN (Blood Urea Nitrogen) — Having a low BUN before dialysis can increase the risk.
  • Younger age — It is more common in younger patients, this is possibly due to higher brain elasticity.
  • Newly initiated dialysis — The risk is higher during the early stages of dialysis treatment.
  • Severe metabolic acidosis — A significant imbalance in acid-base status can be a contributing factor.
  • Low body weight — Patients with lower body weight may be more susceptible to dialysis equilibrium syndrome.

It is important for your medical providers to monitor and manage these factors to reduce the risk of dialysis equilibrium syndrome in people undergoing hemodialysis.


Dialysis equilibrium syndrome is a rare but serious complication associated with hemodialysis. Symptoms can include:

  • Immediate dialysis adjustments — Stopping or slowing down the dialysis, to prevent further shifts in electrolytes.
  • Supportive care — Managing symptoms, such as neurological symptoms or seizures, with appropriate medical interventions.
  • Electrolyte correction — Correcting imbalances in electrolytes, especially sodium.
  • Monitoring — Continuous monitoring of vital signs and laboratory results to assess and manage complications.
  • Prevention — Adjusting dialysis parameters to minimize your risk of the syndrome in future sessions.

Individualized care is important, and medical providers personalized treatment based on the severity of your symptoms and your overall health condition. It is important to seek immediate medical attention if someone is suspected of having dialysis equilibrium syndrome.

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