Dialysis Disequilibrium Syndrome Induced Seizure Following Hemodialysis

Dialysis Disequilibrium Syndrome (DDS) is a set of neurological signs and symptoms that can occur during or following dialysis. Osmotic fluid gradient alteration caused by the dialysis process can cause cerebral edema. This process relates to the changes of high gradient urea in both the blood and central nervous system (CNS), which can modulate extracellular fluid influx into brain cells. A 77-year-old woman presented with chronic kidney disease (CKD) and hypertension with headache and tonic-clonic seizure following initial hemodialysis. In this case, we identified that adjustment to the hemodialysis prescriptions such as duration, blood flow rate, and target reduction of blood urea would be the key to avoid seizure following hemodialysis.