seizures on dialysis

[Lillupie]

I keep reading about us dialysis patients. So many people on dialysis have seizures. My arms and legs like to jerk at times on their own but I dont think its a seizure. Earlier this year this happened when i was sleeping and I feel out of bed on the edge of my nightstand, and busted my head open.
 THere seems to be a number of patients/ my friends on dialysis who get full blown seizures. I am wondering why that is.

Lisa

[Hanify]

For me it was always a fluid issue.  They were taking too much fluid off, and we didn't know about ihd - i.e didn't know how to stick up for ourselves about it.  After a couple of major seizures we learnt to insist that only 1.5 kgs ever be taken off - no matter what!!  My body just couldn't stand any more than that.  Your legs are a different thing I think.

[monrein]

http://www.uptodate.com/patients/content/topic.do?topicKey=~IIOItricih9Qca/

INTRODUCTION
 — Seizures are not uncommon in patients undergoing hemodialysis [1]. Since they are more frequent in those who require acute dialysis for a severe uremic state, the current trend toward earlier initiation of dialysis has resulted in a lower incidence of seizures among these patients.

Seizure activity generally tends to occur during or shortly after the dialysis procedure because of the hemodynamic and biochemical changes associated with the process [1]. Preventive measures should therefore be initiated in patients with predisposing factors, such as extreme uremia or severe electrolyte abnormalities [2].

This topic will review the causes and treatment of seizures in dialysis patients. The management of seizures in patients without renal failure and a review of the acute complications which may occur during dialysis are presented separately. (See "Overview of the management of epilepsy in adults" and see "Acute complications during hemodialysis").

CAUSES
 — Many of the causes of seizures are similar in those with and without renal failure. However, some are specifically related to patients with uremia:

Uremic encephalopathy
Dialysis disequilibrium syndrome
Drugs, such as erythropoietin, carbapenem and ertapenem
Hemodynamic instability, whether hypotension or hypertension
Cerebrovascular disease, such as hypertensive encephalopathy, infarction, hemorrhage, and subdural hematoma
Dialysis dementia due to aluminum intoxication
Electrolyte disorders, such as hypercalcemia, hypocalcemia, hypoglycemia, hyperglycemia, hyponatremia, and hypernatremia
Alcohol withdrawal (see "Management of moderate and severe alcohol withdrawal syndromes")
Air embolism (see "Air embolism")
These factors, either alone or in combination, may result in severe central nervous system dysfunction. In patients without renal failure, the presence of one such abnormality may be tolerated without seizure. However, since the threshold for seizure is lower among those with uremia and/or multiple electrolyte disorders, the addition of another central nervous system (CNS) insult, such as aggressive dialysis, may result in seizure activity.


This is an excerpt from a scholarly article.  I couldn't access the entire article because one must subscribe to do so but it does address in a general way the issue of seizures in dialysis patients.   There are so many things going awry in the bodies of ESRD patients that all sorts of weird things can occur.  This is one of the major reasons that I do not think it wise to delay dialysis until the last gasp since irreversible damage can also occur if the body is ignored as it struggles to do what it was designed to do. 

[KICKSTART]

I keep reading about us dialysis patients. So many people on dialysis have seizures. My arms and legs like to jerk at times on their own but I dont think its a seizure. Earlier this year this happened when i was sleeping and I feel out of bed on the edge of my nightstand, and busted my head open.
 THere seems to be a number of patients/ my friends on dialysis who get full blown seizures. I am wondering why that is.

Lisa

For arms and legs jerking on their own read up about RLS (restless leg syndrome) a lot of us get it ! I like to call it restless body syndrome , as you can get that feeling all over !

[pamster42000]

Sarah had three seizure episodes each happening in the hospital.  On the third one I decided to send her to the hospital in Omaha because her nephroligist's  (spell check didn't show a different spelling for this, not certain if I spelled it right) said he couldn't figure out why. He got mad at me for sending her to Omaha. Well anyway the Dr's at Omaha said the seizures may have been caused by receiving too much Epogen. Never did get a clear answer. Medication kept the seizures under control.