Dialysis headache in patients undergoing peritoneal dialysis and hemodialysis.
OBJECTIVE
Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but still under investigated in peritoneal dialysis (PD) patients. The aim of this study was to assess the incidence and clinical characteristics of dialysis headache (DH) in HD and PD patients.


METHODS
A total of 409 patients (91 on PD and 318 on HD) were interviewed using a structured questionnaire, designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. Patients with DH underwent a thorough neurological examination.


RESULTS
DH was reported by 21 (6.6%) HD patients and 0 PD patients. PD patients had significantly lower serum sodium, potassium, calcium, phosphate, urea and creatinine, calcium-phosphate product, and diastolic blood pressure than HD patients. HD patients had significantly lower hemoglobin compared to PD patients. Primary renal disease was mostly parenchymal in HD patients, and vascular in PD patients. DH appeared more frequently in men, mostly during the third hour of HD. It lasted less than four hours, was bilateral, non-pulsating and without associated symptoms.


CONCLUSIONS
Biochemical alterations may be implicated in the pathophysiology of DH. Specific features of DH might contribute to better understanding of this secondary headache disorder.
Clinic of Nephrology, Clinical Center of Serbia , Belgrade , Serbia .
Biljana
B
Stojimirovic
Marija
M
Milinkovic
Jasna
J
Zidverc-Trajkovic
Jasna
J
Trbojevic-Stankovic
Ivko
I
Maric
Miodrag
M
Milic
Branislav
B
Andric
Petar
P
Nikic
D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods; D003404:Creatinine / Q000097:blood; D005260:Female; D006261:Headache / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D055771:Serbia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014508:Urea / Q000097:blood
D006454:Hemoglobins; D014508:Urea; D003404:Creatinine
End-stage renal disease; headache; hemodialysis; peritoneal dialysis