Around 70% of dialysis patients suffer with headaches either before, during or immediately after completing their dialysis treatment. Although the specific causes are largely unknown, professionals believe that Dialysis Disequilibrium Syndrome (DDS) may be a main contributor. It is related to cerebral swelling and fluid shifts after removing high levels of urea during dialysis and can lead to restlessness, cluster headaches, mental confusion and even coma. However, headaches are not specific to DDS in people on dialysis and other causes may include hypertension (high blood pressure), hypotension (low blood pressure), high sodium intake, and a possible connection with low magnesium. In rare cases severe headaches can be associated with other serious conditions so any recurring headaches should be taken seriously and brought to the attention of your Nephrologist to identify the precise cause.
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Try pinpointing your issue by checking your labs, medications and diet. When do you get headaches? First start with your blood pressure, how is it? From there find out how many kilos of fluid you are above your dry weight and if it is ideal for you. Are you taking too much off or too little off during your treatment? When conducting dialysis people often try to remove as much fluid as they can in relatively short periods of time and that can create many issues including hypotension and as a result cluster headaches. Also, consider the possibility of blood clotting which can interrupt your blood circulation and cause imbalances in your body leading to a possible stroke or heart attack.
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Consistently monitor your labs and make necessary adjustments when needed. If this matter persists KidneyBuzz.com encourages you to discuss with your Nephrologist another modality that works for you such as Short Daily or Nocturnal Dialysis. Healthy kidneys do much of their work while you are asleep which helps to keep your body balanced. That is why some suggest that Home Nocturnal Dialysis is the treatment option that best mimics a "normal" functioning kidney, aside from a transplant.
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Your Nephrologist can prescribe medications that you can take with relative safety as a dialysis patient and for more immediate temporary relief call your Pharmacist to confirm Tylenol is alright for you to use, but studies have recommended that dialysis patients should never use Advil or Aleve. In general, pain relievers will only help you alleviate your headache momentarily so you should still review your regular lab work to identify any changes and continue to work with your healthcare team to find the underlying cause of your headaches.
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"Saying Goodbye to Headaches." Dialysis from the Sharp End of the Needle.
Zepeda-Orozco, Diana, and Raymond Quigley. "Dialysis Disequilibrium Syndrome."National Center for Biotechnology Information. U.S. National Library of Medicine
"Why Do I Get a Migraine after Dialysis?" Health Central.
"Headache and Hemodialysis: Evaluation of the Possible Triggering Factors and of the Treatment." National Center for Biotechnology Information. U.S. National Library of Medicine
"Kidney Patient News." Problems with Dialysis.