Dysequilibrium Syn

Dialysis dysequilibrium syndrome

  • A clinical diagnosis, no specific diagnostic test.
  • Need to rule out other causes
  • Main symptoms: headache, nausea, blurred vision, restlessness
    • If severe; decreased Level of consciousness. seizure, coma
  • Seen in patients
    • first started on dialysis or
    • missed multiple dialysis
  • Risk factors
    • BUN over 175
    • extremes of age
    • hyponatremia, hepatic encephalopathy, hypertensive emergency
      • Increased permeability of Blood brain barrier
        • sepsis, vasculitis, TTP, hemolytic uremic syndrome, encephalitis
    • May need to shorten or reduce blood flow on dialysis
    • If severe: hypertonic saline or mannitol