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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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Autores principales: Athavale, Akshay, Wyburn, Kate R, Snelling, Paul L, Chadban, Steven J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888092/
https://www.ncbi.nlm.nih.gov/pubmed/35242392
http://dx.doi.org/10.1155/2022/4964033
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author Athavale, Akshay
Wyburn, Kate R
Snelling, Paul L
Chadban, Steven J
author_facet Athavale, Akshay
Wyburn, Kate R
Snelling, Paul L
Chadban, Steven J
author_sort Athavale, Akshay
collection PubMed
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.
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spelling pubmed-88880922022-03-02 Dialysis Disequilibrium: Is Acidosis More Important than Urea? Athavale, Akshay Wyburn, Kate R Snelling, Paul L Chadban, Steven J Case Rep Nephrol Case Report 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. Hindawi 2022-02-22 /pmc/articles/PMC8888092/ /pubmed/35242392 http://dx.doi.org/10.1155/2022/4964033 Text en Copyright © 2022 Akshay Athavale et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Athavale, Akshay
Wyburn, Kate R
Snelling, Paul L
Chadban, Steven J
Dialysis Disequilibrium: Is Acidosis More Important than Urea?
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?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888092/
https://www.ncbi.nlm.nih.gov/pubmed/35242392
http://dx.doi.org/10.1155/2022/4964033
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