title: Dialysis disequilibrium syndrome occurring during continuous renal replacement therapy.
abstract: The dialysis disequilibrium syndrome (DDS) is characterized by progressive neurological symptoms and signs attributable to cerebral edema that occurs due to fluid shifts into the brain following a relatively rapid decrease in serum osmolality during hemodialysis (HD). Since continuous renal replacement therapy (CRRT) is less efficient at solute clearance than intermittent HD, it seems logical that this mode of therapy is less likely to cause DDS. This entity has not been previously reported to occur with this modality. Here, we report two cases of DDS associated with CRRT that provide insights into its pathophysiological mechanisms and suggest strategies for its prevention.
authors.affiliation: Division of Pediatric Nephrology , Children's National Medical Center , Washington, DC , USA.
authors.forename: Shamir
authors.initials: S
authors.lastname: Tuchman
authors.affiliation: Division of Diagnostic Imaging and Radiology , Children's National Medical Center , Washington, DC , USA.
authors.forename: Zarir P
authors.initials: ZP
authors.lastname: Khademian
authors.affiliation: Division of Pediatric Nephrology , Children's National Medical Center , Washington, DC , USA.
authors.forename: Kirtida
authors.initials: K
authors.lastname: Mistry
keywords: CRRT; dialysis; disequilibrium; osmolality; renal failure