Intermittent Dialysis Leading to Dialysis Disequilibrium Syndrome

Kalyani Regeti, Waqas Jehangir, Sherry Kumar, Chadrick Chua, Abdalla Yousif, Shuvendu Sen


Dialysis disequilibrium syndrome (DDS) is a critical and ultimately fatal condition that presents in hemodialysis patients. Serious manifestations of DDS involve impaired concentration, disorientation, and coma. Risk factors for the condition include dialysis treatment, elevated BUN, renal disease, metabolic acidosis, and pre-existing neurologic disease. There are three main theories proposed to account for the development of DDS, including a reverse urea effect, idiogenic osmoles, and paradoxical brain acidosis. Each of these theories potentiates cerebral edema, and eventually brain herniation, that leads to death. This case examines a 33-year-old Hispanic male brought to the emergency room. He was admitted to the ICU based on hospital findings and had a metabolic acidosis that persisted despite appropriate initial treatment. He was eventually placed on hemodialysis over the course of 2 weeks, and ultimately expired from DDS. This paper aims to demonstrate that hemofiltration is a superior alternative in patients where hemodialysis is indicated, so that DDS, and subsequent fatality, can be avoided.

World J Nephrol Urol. 2015;4(3):247-250


Dialysis disequilibrium syndrome; Herniation; Hemodialysis

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics






World Journal of Nephrology & Urology, quarterly, ISSN 1927-1239 (print), 1927-1247 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada
© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.