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

10 patients suffering from severe headache during Acetatedialysis were subsequently treated with Acetatedialysis (AD) and Bicarbonatedialysis (BD). During AD the headaches occurred more frequently and more intensely. After AD a deterioration of EEG-results was also seen more frequently than after BD. Urea, osmolarity and sodium in the blood as well as heart frequency and blood pressure showed no different variation. An essential difference was found in correction of the metabolic acidosis. After AD there could be seen a negative base excess and a fall in PaCO2, after BD the PaCO2 rose and the base excess was positive. Headaches and EEG-changes as signs of a cerebral dysfunction (disequilibrium syndrome) may perhaps be caused by a decrease of the cerebral blood flow. From our experience we recommend a change to BD for patients suffering from headaches during AD.