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Dialysis Headache: A Narrative Review.
Eduardo Sousa Melo1, Filipe Carrilho Aguiar1, Pedro Augusto Sampaio Rocha-Filho2,3
1Hospital das Clinicas, Universidade de Pernambuco, Recife, Brazil).
Headache
|June 29, 2016
Summary
Dialysis headache affects many patients undergoing hemodialysis, causing significant discomfort. Understanding its causes and developing effective treatments remain challenging for medical professionals.
Area of Science:
- Nephrology
- Neurology
- Headache Medicine
Background:
- Chronic kidney disease patients undergoing dialysis report poor quality of life.
- Dialysis headache is a common and challenging complication of hemodialysis.
Purpose of the Study:
- To review the current understanding of dialysis headache, including its prevalence, characteristics, potential pathophysiology, and management.
Main Methods:
- This study was a narrative review of existing literature on dialysis headache.
Main Results:
- Dialysis headache prevalence ranges from 27% to 73%, often presenting as pulsatile, frontal, moderate-to-severe pain hours after dialysis, sometimes with nausea/vomiting.
- Potential pathophysiological factors include fluctuations in urea, electrolytes, blood pressure, weight, and the hematoencephalic barrier's role in fluid shifts, alongside neurochemicals like nitric oxide.
- Current prevention strategies involve volume and electrolyte control, blood pressure management, and avoiding caffeine, but evidence-based prophylactic or abortive treatments are lacking.
Conclusions:
- Hemodialysis headache is prevalent but understudied, hindering understanding of its mechanisms.
- Clinical management of dialysis headache is largely empirical due to a lack of robust evidence.
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