By Shivani Ghoshal, Jonathan Gomez, Aarti SarwalFirst Online:
24 July 2019
Dialysis disequilibrium syndrome (DDS) is a constellation of signs and symptoms including nausea, headache, seizures, encephalopathy, and even herniation and death . The syndrome is thought to originate from osmolar shifts in dialysis leading to an acute increase in brain water, cerebral edema, and reduced brain compliance [1, 2, 3, 4]. End-stage renal disease (ESRD) patients with new acute neurologic injury involving compromise of the blood–brain barrier may be at particular risk of DDS [4, 5, 6].
Here, we present transcranial Doppler (TCD) images revealing marked intra-dialytic increased distal vascular resistance and compromised flow velocity in ESRD patient with acute traumatic brain injury. Trends in pulsatility indices during hemodialysis may be a useful noninvasive bedside method to monitor for dialysis disequilibrium in ESRD patients with acute neurologic injury.Read full article