Dialysis Disequilibrium: Is Acidosis More Important than Urea?
Dialysis disequilibrium syndrome is a severe complication associated with dialysis treatment. Manifestations may range from mild such as headache to severe such as seizures and coma. Risk factors for development include initial dialysis treatment, uraemia, metabolic acidosis, and extremes of age. We...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2022/4964033 |
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| author | Akshay Athavale Kate R Wyburn Paul L Snelling Steven J Chadban |
| author_facet | Akshay Athavale Kate R Wyburn Paul L Snelling Steven J Chadban |
| author_sort | Akshay Athavale |
| collection | DOAJ |
| description | Dialysis disequilibrium syndrome is a severe complication associated with dialysis treatment. Manifestations may range from mild such as headache to severe such as seizures and coma. Risk factors for development include initial dialysis treatment, uraemia, metabolic acidosis, and extremes of age. We report a case of dialysis disequilibrium in a patient with a failing kidney transplant secondary to the recurrence of IgA nephropathy. Disturbance in cognition and neurologic functioning occurred six hours after the completion of initiation of intermittent haemodialysis. During two sessions of intermittent haemodialysis of 3 and 4 hours, urea was reduced by 21.9 and 17.2 mmol/L and measured serum osmolality was reduced by 25 and 14 mOsm/kg, respectively. Subsequent admission to the intensive care unit and initiation of continuous renal replacement therapy for 48 hours resulted in complete resolution of symptoms. In this case report, we discuss atypical clinical and radiologic features of dialysis disequilibrium occurring with modest reductions in urea and serum osmolality. |
| format | Article |
| id | doaj-art-c43deeff7bb84ca0ab42cf67fb8e6c16 |
| institution | DOAJ |
| issn | 2090-665X |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-c43deeff7bb84ca0ab42cf67fb8e6c162025-08-20T03:23:11ZengWileyCase Reports in Nephrology2090-665X2022-01-01202210.1155/2022/4964033Dialysis Disequilibrium: Is Acidosis More Important than Urea?Akshay Athavale0Kate R Wyburn1Paul L Snelling2Steven J Chadban3Department of Renal MedicineDepartment of Renal MedicineDepartment of Renal MedicineDepartment of Renal MedicineDialysis disequilibrium syndrome is a severe complication associated with dialysis treatment. Manifestations may range from mild such as headache to severe such as seizures and coma. Risk factors for development include initial dialysis treatment, uraemia, metabolic acidosis, and extremes of age. We report a case of dialysis disequilibrium in a patient with a failing kidney transplant secondary to the recurrence of IgA nephropathy. Disturbance in cognition and neurologic functioning occurred six hours after the completion of initiation of intermittent haemodialysis. During two sessions of intermittent haemodialysis of 3 and 4 hours, urea was reduced by 21.9 and 17.2 mmol/L and measured serum osmolality was reduced by 25 and 14 mOsm/kg, respectively. Subsequent admission to the intensive care unit and initiation of continuous renal replacement therapy for 48 hours resulted in complete resolution of symptoms. In this case report, we discuss atypical clinical and radiologic features of dialysis disequilibrium occurring with modest reductions in urea and serum osmolality.http://dx.doi.org/10.1155/2022/4964033 |
| spellingShingle | Akshay Athavale Kate R Wyburn Paul L Snelling Steven J Chadban Dialysis Disequilibrium: Is Acidosis More Important than Urea? Case Reports in Nephrology |
| title | Dialysis Disequilibrium: Is Acidosis More Important than Urea? |
| title_full | Dialysis Disequilibrium: Is Acidosis More Important than Urea? |
| title_fullStr | Dialysis Disequilibrium: Is Acidosis More Important than Urea? |
| title_full_unstemmed | Dialysis Disequilibrium: Is Acidosis More Important than Urea? |
| title_short | Dialysis Disequilibrium: Is Acidosis More Important than Urea? |
| title_sort | dialysis disequilibrium is acidosis more important than urea |
| url | http://dx.doi.org/10.1155/2022/4964033 |
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