Dialysis Disequilibrium Syndrome (DDS) Quiz
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What is Dialysis Disequilibrium Syndrome (DDS)?
Dialysis disequilibrium syndrome occurs when a group of neurological symptoms arise in patients on hemodialysis due to the sudden and rapid removal of urea, a waste product, from their blood. These symptoms include nausea, headaches, vomiting, and restlessness. More severe symptoms can lead to seizures and comas.
Typical Symptoms of Dialysis Disequilibrium Syndrome (DDS)
- Kidney failure on dialysis
- Headache
- Leg cramps
- Nausea or vomiting
- Seizure
- Pain in the temples
- Stomach or abdominal pain
- Fatigue or low energy
Diagnostic Questions for Dialysis Disequilibrium Syndrome (DDS)
Your doctor may ask these questions to check for this disease:
- Are you currently on dialysis?
- Do you have a headache?
- Have you experienced leg cramps lately?
- Have you been experiencing nausea or vomiting?
- Have you experienced any seizures?
Treatment of Dialysis Disequilibrium Syndrome (DDS)
Your doctor may prescribe fluids and some medications aimed at reducing the pressure in your head to alleviate the symptoms. After that, your hemodialysis prescription will likely be adjusted to prevent future recurrences.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 19, 2025
Following the Medical Content Editorial Policy
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Mistry K (2019). Dialysis disequilibrium syndrome prevention and management. International journal of nephrology and renovascular disease.
https://pubmed.ncbi.nlm.nih.gov/31118737/Raina R, et al. (2021). Dialysis disequilibrium syndrome (DDS) in pediatric patients on dialysis: systematic review and clinical practice recommendations. Pediatric nephrology (Berlin, Germany).
https://pubmed.ncbi.nlm.nih.gov/34609583/Genena KH, et al. (2021). Half the V by 120: A practical approach to the prevention of the dialysis disequilibrium syndrome. Hemodialysis international. International Symposium on Home Hemodialysis.
https://pubmed.ncbi.nlm.nih.gov/34145961/