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Hyponatremia induced disequilibrium syndrome in regular hemodialysis: a case report and review of literature

Urology & Nephrology Open Access Journal
Ahmed Akl,1,2,3 Abdulaziz Osailan,2 Hanan Faruqui2

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Hemodialysis Disequilibrium Syndrome (HDS) is characterized by rapid change of the osmotic gradient between brain and the plasma during hemodialysis leading to neurological manifestations. It is usually attributed to rapid and aggressive hemodialysis. HDS can have various neurological manifestations starting with headache, nausea, vomiting, muscle cramps, tremors up to disturbed consciousness and convulsions. In severe cases, patients can die from advanced cerebral edema. Blood urea play a major role in disequilibrium. In our case, we focus on the serum electrolytes mainly sodium as a contributor for HDS.


hyponatremia, cerebral oedema, acute renal failure, chronic renal failure