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Dialysis disequilibrium syndrome : ウィキペディア英語版 | Dialysis disequilibrium syndrome
In nephrology, dialysis disequilibrium syndrome, commonly abbreviated DDS, is the occurrence of neurologic signs and symptoms, attributed to cerebral edema, during or following shortly after intermittent hemodialysis.〔 (Free Full Text ).〕 Classically, DDS arises in individuals starting hemodialysis due to chronic renal failure and is associated, in particular, with "aggressive" (high solute removal) dialysis.〔 (Free Full Text ).〕 However, it may also arise in fast onset, i.e. acute, renal failure in certain conditions. ==Etiology== The cause of DDS is currently not well understood. There are two theories to explain it; the first theory postulates that urea transport from the brain cells is slowed in chronic renal failure, leading to a large urea concentration gradient, which results in reverse osmosis. The second theory postulates that organic compounds are increased in uremia to protect the brain and result in injury by, like in the first theory, reverse osmosis.〔 More recent studies on rats noted that brain concentrations of organic osmolytes were not increased relative to baseline after rapid dialysis. Cerebral edema was thus attributed to osmotic effects related to a high urea gradient between plasma and brain.〔http://jasn.asnjournals.org/content/6/6/1600.long〕
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