Seizure in hemodialysis patients

Abstract

Seizures are one of the relatively common and at the same time important and serious complications of hemodialysis. Although several reasons have been suggested for seizures in this group of patients, none of them are conclusive, the debate is still ongoing. Obviously, by identifying these possible factors, hemodialysis-related seizures can be prevented by taking preventive measures. The final achievement would be lowered costs and health problems which have been imposed on the patient and the public care and health system. The aim of this study was to identify these possible factors and use them to prevent seizures in hemodialysis patients.

Methods and Materials: The incidence of seizures in patients under hemodialysis was evaluated during a 13-month period. Thereafter, 30 patients with hemodialysis related seizure (the case group) were compared with 30 counterparts without seizure (the control group). Patients with the seizure occurred during hemodialysis or at most, 24 hours after hemodialysis considered eligible. The age, electroencephalography (EEG) and the blood laboratory findings were compared between the two groups. EEG and the blood tests were done during the first 24 hours after hemodialysis. Results: Seizure occurred in thirty-three (%14.80) cases out of 223patients received hemodialysis. The total (p=0.009) and ionized (p=0.003) serum Ca were significantly lower in the case group (6.94±0.82 vs. 7.65±1.18, 3.62±0.41 vs. 4.02±0.58, respectively). Also, hypocalcemia was significantly higher in the case group (p=0.024). Acidosis was seen in all the studied patients; however, the severity of acidosis in the case group was higher the control group (p=0.034). Predominant rhythm of EEG in the case patients was slow wave activity (89.7%). There was no significant difference of age between patients in the two groups (p=0.742).