Hemodialysis-related headache and how to prevent it

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Hemodialysis-related headache and how to prevent it
Key Take-Away: 

Dialysis is associated with the problem of headache as there is a large quantity of electrolyte and water shifts. This problem associated with dialysis can cause severe issues which makes its management even more challenging, and this study explains the approaches through which this issue can be controlled.

Introduction
The people who went through hemodialysis (HD) show some nervous system related adverse effects (AEs), and one of the significant AE is the headache. The study aimed to the evaluate the clinical features, frequency and triggering factors of an HD-related headache (HRH) and to assess preventive approaches to overcome HRH.

 

Method
A total of 494 patients were selected. The comparative controls (CC) were analysed in the same patients without headache. Creatinine, arterial systolic/diastolic blood pressure, and blood urea nitrogen (BUN) were compared before/after one HD. During the dialysis session, the urea reduction ratio was also discovered.

 

Results
A total of 175 patients with mean age of 57.3 ± 15.7 years were diagnosed with HRH. Males were more prone to HRH as compared to females. The mean time noticed after HD at which the headache started was 2.90 ± 0.86 hours. 41.7% of patients reported bifrontal pain. The average duration of headache noticed was 6.22 ± 7.8 h, with a period of ≤4 h expressed by 64.0% of patients. Mean Visual Analog Scale score demonstrated by the patients was 5.64 ± 2.05. The pre/post-dialysis BUN values difference between the CC and HRH groups noticed was 86.8 ± 28.5 and 94.6 ± 31.1, respectively (P = 0.006). The CC and HRH groups showed 12.8 ± 19.4 mmHg and 22.4 ± 16.5 mmHg systolic blood pressure difference between the pre/post-dialysis measurements (P < 0.001). Higher mean systolic and diastolic blood pressure pre-dialysis values were noticed in HRP group than CC group (systolic, P = 0.002; diastolic, P < 0.001).

 

Conclusion
Controlling the timing and frequency of dialysis may implement better HRH management with high pre-dialysis blood pressure and high BUN levels.

Source:

Eur J Neurol

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/30102816

Original title of article:

Hemodialysis related headache

Authors:

Gozubatik‐Celik et al.

Therapeutic, Headache, Head, Efficacy
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