Haemodialysis Disequilibrium

Rosen, S. M.; O'Connor, K.; Shaldon, Stanley

doi:10.1136/bmj.2.5410.672

Cited by 82 publications

(39 citation statements)

References 8 publications

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“…The arterial blood gas response to dialysis, though, was the same as that reported by other authors, i.e., metabolic acidosis with compensatory respiratory alkalosis proceeding to respiratory alkalosis, in spite of correcting the metabolic deficit [1,4,11], Cowie et al [4] have demonstrated the persist ence and, in some cases, the worsening of metabolic acidosis in the CSF at the termination of dialysis. The time course of these changes during hemodialysis and their relationship to the development of disequilibrium symptoms are yet to be defined.…”

Section: Discussionsupporting

confidence: 77%

“…The arterial blood gas and pH determinations in all group II patients were altered by dialysis in the same way as reported by others [1,4,11], i.e., meta bolic acidosis to mild respiratory alkalosis, with the PaCOa remaining relatively constant (28-34 mm Hg).…”

Section: Resultsmentioning

confidence: 74%

“…There is general agreement in the literature that the pathogenesis of this syndrome probably lies in two factors that occur with the onset of dialysis: the develop ment of osmolar gradients between extracellular and intracellular fluid and the ultrafiltration of water [7,8,10,11]. The manipulation of one or both of these factors can relieve or curtail the symptoms [5,7,13].…”

Section: Introductionmentioning

confidence: 99%

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Colloid Osmotic Pressure Fluctuations and the Disequilibrium Syndrome during Hemodialysis

Cerra

Anthone

1974

Nephron

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Changes in colloid osmotic pressure (COP), osmolality, blood urea nitrogen, glucose, electrolytes and arterial blood gases were correlated with the symptoms that occurred during 46 dialyses in 10 stable, chronic hemodialysis patients who had symptoms attributable to the disequilibrium syndrome. The onset and severity of symptoms were consistently related to fluctuations in COP. Saline administration failed to relieve them, whereas the continuous infusion of salt-poor human serum albumin (1 g/kg) or mannitol (1 g/kg) successfully controlled the COP fluctuations and most of the symptomatology. The relationship of the COP fluctuations to existing theories on the pathogenesis of the disequilibrium syndrome were discussed.

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Section: Discussionsupporting

confidence: 77%

Section: Resultsmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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Colloid Osmotic Pressure Fluctuations and the Disequilibrium Syndrome during Hemodialysis

Cerra

Anthone

1974

Nephron

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“…It was first attributed to a gradient in the urea content between plasma and brain occurring during acute hemodialysis due to a faster removal of plasma urea than brain urea. The "reverse urea effect" introduced by Pappius et al (4) was supported by several other laboratories reporting higher urea concentrations in the CSF than plasma (1,30). Moreover, DDS could be partially corrected by maintaining plasma osmolality during dialysis by adding urea (31) or mannitol (32), or by increasing sodium concentration of the dialysate (33).…”

Section: Discussionmentioning

confidence: 97%

Hemodialysis increases apparent diffusion coefficient of brain water in nephrectomized rats measured by isotropic diffusion-weighted magnetic resonance imaging.

Galons¹,

Trouard²,

Gmitro³

et al. 1996

J. Clin. Invest.

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“…DDS as is well known, is characterized by neurological symptoms of various importance and gravity (cramps, headaches, vomiting and even disorientation, psychosis and coma) [1,[12][13][14][15] and shows a typical EEG pattern [1,6,7,10,13,14]. Arieff ct al.…”

Section: Discussionmentioning

confidence: 99%

Studies on Brain Density in Hemodialysis and Peritoneal Dialysis

Greca

Biasioli

Chiaramonte

et al. 1982

Nephron

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30 patients on hemodialysis or peritoneal dialysis have been investigated by computerized tomographic (CT) scan. To evaluate possible cerebral alterations induced by dialysis, CT examinations were carried out before, immediately after and 6 h after the end of dialysis with an Evaluskop, which provides an objective precise evaluation of even slight variations in brain density. No morphological variations were noted after dialysis, while the brain density fell significantly during and after the treatment. A decrease in density was not observed in normal subjects or in patients on continuous peritoneal dialysis. The changes in the densitometric values of brain tissue suggest that there is a postdialysis gain in cerebral water linked to the intermittent treatment. CT may represent a simple reliable method for studying uremic encephalopathy and investigating the pathogenesis of the dialysis disequilibrium syndrome.

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Haemodialysis Disequilibrium

Cited by 82 publications

References 8 publications

Colloid Osmotic Pressure Fluctuations and the Disequilibrium Syndrome during Hemodialysis

Colloid Osmotic Pressure Fluctuations and the Disequilibrium Syndrome during Hemodialysis

Hemodialysis increases apparent diffusion coefficient of brain water in nephrectomized rats measured by isotropic diffusion-weighted magnetic resonance imaging.

Studies on Brain Density in Hemodialysis and Peritoneal Dialysis

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