Dialysis disequilibrium syndrome (DDS): clinical features

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Dialysis disequilibrium syndrome (DDS): clinical features. This develops at the start of haemodialysis. Fully referenced neurology checklist.

Pathological features

  • This develops at the start of haemodialysis
  • It results from rapid removal of urea
  • This causes an osmotic shift of fluid into the brain parenchyma
  • It may occur during dialysis or be delayed up to 24 hours post- dialysis
  • It lasts a few hours

Risk factors

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Clinical features

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Differential diagnosis

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References

  1. Sprague SM, Corwin HL, Tanner CM, Wilson RS, Green BJ, Goetz CG. Relationship of aluminum to neurocognitive dysfunction in chronic dialysis patients. Arch Intern Med 1988; 148:2169-2172.
  2. Bellamkonda A, Chowdhury T, Shankar M, Gousy N. Dialysis disequilibrium syndrome: a red flag to check post hemodialysis. Cureus 2022; 14:e24619. 
  3. Chang CH, Hsu KT, Lee Chet al. Leukoencephalopathy associated with dialysis disequilibrium syndrome. Ren Fail 2007; 29:631-634.
  4. Adapa S, Konala VM, Aeddula NR, Gayam V, Naramala S. Dialysis disequilibrium syndrome: rare serious complication of hemodialysis and effective management. Cureus 2019; 11:e5000.
  5. Mistry K. Dialysis disequilibrium syndrome prevention and management. Int J Nephrol Renovasc Dis 2019; 12:69-77.
  6. And 5 more. Subscribe to see the full list

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