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Journal of Korean Neurosurgical Society > Volume 30(3); 2001 > Article
Journal of Korean Neurosurgical Society 2001;30(3): 381-383.
Dialysis Disequilibrium Syndrome in Neurosurgical Patient.
Hee Kyung Woo, Do Sung Yoo, Dal Soo Kim, Pil Woo Huh, Kyoung Suok Cho, Joon Ki Kang
Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
ABSTRACT
Neurological symptoms may develope when the blood urea nitrogen is lowered too rapidly by hemodialysis. It is known that these symptoms, known as dialysis disequilibrium are associated with cerebral edema. However, the pathogenesis of brain swelling and neurological deterioration after rapid hemodialysis is controversial. The reverse urea hypothesis suggests that hemodialysis removes urea more slowly from the brain than from the plasma, creating an osmotic gradient that results in cerebral edema. The idiogenic osmole hypothesis proposes that an osmotic gradient between brain and plasma develops during rapid dialysis because of newly formed brain osmoles. Authors report a such case and discuss the possible mechanism and preventive methods.
Key Words: Dialysis disequilibrium syndrome; Hemodialysis; Brain edema
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