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Dialysis disequilibrium syndrome revisited: Feeling "Disequilibrated" due to inner ear dyshomeostasis?
Chang-Hee Kim1, Jung Eun Shin1, Jung Hwan Park2
1Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
Abstract:
Dizziness is one of the most common hemodialysis-associated symptoms, and has been thought to be caused by cerebral edema or intravascular hypovolemia. However, the possibility of a peripheral vestibular disturbance due to hemodialysis has not been addressed as a cause of hemodialysis-associated dizziness. In the present study, we propose a new hypothesis accounting for hemodialysis-associated dizziness, i.e., the decrease in serum osmolality due to rapid removal of urea during dialysis causes inner ear fluid dyshomeostasis, leading to density difference between perilymph and endolymph.