[Headache and EEG changes caused by acetate and bicarbonate dialysis]

Area of Science:

• Nephrology
• Neurology

Background:

• Dialysis can cause adverse neurological symptoms like severe headaches.
• Acetate dialysis (AD) and Bicarbonate dialysis (BD) are common dialysis methods with differing physiological effects.

Purpose of the Study:

• To compare the incidence and severity of headaches and EEG changes between AD and BD.
• To investigate the underlying physiological differences contributing to these symptoms.

Main Methods:

• A cohort of 10 patients experiencing headaches during AD were switched to BD for comparison.
• Clinical symptoms (headaches, EEG) and blood parameters (urea, osmolarity, sodium, PaCO2, base excess) were monitored.

Main Results:

• Headaches were more frequent and intense during AD compared to BD.
• EEG deterioration was observed more often after AD than BD.
• Significant differences in acid-base balance correction were noted: AD led to negative base excess and decreased PaCO2, while BD resulted in positive base excess and increased PaCO2.

Conclusions:

• Headaches and EEG changes during dialysis may indicate cerebral dysfunction potentially linked to reduced cerebral blood flow.
• Bicarbonate dialysis (BD) appears to be a safer alternative to Acetate dialysis (AD) for patients experiencing headaches.
• Switching to BD is recommended for patients suffering from headaches during AD.