Hemodialysis‐related headache: Still a challenge in 2020? Effect of conventional versus online hemodiafiltration from a study in Casablanca, Morocco

Hazim, Asmâa; Adarmouch, Latifa; Eloury, Aida; Aasfara, Jehanne; Asly, Mouna; Slassi, I.

doi:10.1111/aor.13886

Cited by 7 publications

(11 citation statements)

References 20 publications

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“…The current study revealed a relatively low incidence of HRH compared to prior investigations, which might be attributed to variations in the observation period and advancements in dialysis techniques and prescriptions in recent years [ 1 – 7 ]. Despite the significant association between HRH and a lower quality of life [ 14 ], there exists no consensus on its treatment due to its diverse and complex causes [ 1 – 6 ].…”

Section: Discussionmentioning

confidence: 53%

Association of intradialysis blood sodium level, blood pressure variability, and hydration status with hemodialysis-related headache: a prospective cohort study

Xiong,

You,

Liao

et al. 2023

J Headache Pain

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Objective To identify primary factors contributing to hemodialysis-related headache (HRH) in maintenance hemodialysis (MHD) patients. Methods Adult outpatients receiving MHD were prospectively enrolled from a hemodialysis (HD) center of a tertiary hospital in China. Twelve dialysis sessions were successively monitored for each patient. HRH is defined as having at least three headache episodes that begin during HD and resolve within 72 h of HD session completion. Blood gas analysis during headache episodes and body composition analysis after dialysis were conducted. Hour-to-hour vital sign variability during dialysis was assessed using the metric of average real variability (ARV). Multivariable logistic regression analysis was conducted to explore the factors triggering HRH. Results A total of 95 Chinese MHD patients were enrolled, with 92 patients (60.9% were males) included in the final analysis. The mean age of the 92 patients was 59.3 ± 17.5 years, and the median dialysis vintage was 27.1 (12–46.2) months. Among them, 12 patients (13%) complained of 42 headache attacks, and eight (8.7%) were diagnosed with HRH. For eight patients with HRH, headache occurred 100.3 ± 69.5 min after the start of dialysis, with a mean VAS score of 4.3 ± 1 points. The quality of headaches was dull (six patients), pulsating (one patient), or stabbing pain (one patient); all the headaches were bilateral, with one having concomitant vomiting. The intradialysis headache duration and the whole headache duration were 98.8 ± 68.1 and 120 (65–217.5) minutes, respectively. Younger age (OR = 0.844, 95% CI 0.719–0.991, p = 0.039), decreased blood sodium level (OR = 0.309 in the range of 133–142 mmol/L, 95% CI 0.111–0.856, p = 0.024), increased ARV of intradialysis systolic blood pressure (OR = 3.067, 95% CI 1.006–9.348, p = 0.049) and ratio of overhydration to dry weight (OR = 1.990, 95% CI 1.033–3.832, p = 0.040) were found to be independent risk factors for HRH. Conclusions This study suggested a significant attribution of blood sodium, hydration status and blood pressure variability to HRH.

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Section: Discussionmentioning

confidence: 53%

Association of intradialysis blood sodium level, blood pressure variability, and hydration status with hemodialysis-related headache: a prospective cohort study

Xiong,

You,

Liao

et al. 2023

J Headache Pain

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“…In ICHD-3, the diagnostic criteria for 10.2 HDH did not describe the clinical characteristics of headache. We summarised the clinical characteristics of HDH in the previous literature and our own research, which are shown in Table 4 [ 3 , 5 , 8 , 14 – 17 ], and discovered that HDH has some common characteristics, such as moderate intensity and bilateral frontal-temporal lobe, with a mean duration of less than 4 h. Therefore, it is suggested to add a diagnostic criteria D: “ Headache has one of the following characteristics:1) moderate intensity, 2) located at bilateral frontal-temporal lobe, 3) the mean duration less than four hours. ” Based on the above discussion, we recommend Table 5 as 10.2 new diagnostic criteria for dialysis headaches.…”

Section: Discussionmentioning

confidence: 99%

“…There is no consensus regarding the pathophysiology or triggering factors of headache during haemodialysis (HDH). Factors associated with dialysis headaches include sodium ion, magnesium ion [ 6 ], urea, blood pressure changes, and weight levels; calcitonin gene-related peptide and substance P levels during dialysis [ 7 ]; and different haemodialysis (HD) modalities (standard HD and online hemodiafiltration technique (OL-HDF), standard HD presents a higher risk of dialysis headache than OL-HDF) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The applicability research of the diagnostic criteria for 10.2 Heamodialysis-related headache in the international classification of headache disorders-3rd edition

et al. 2023

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Background Headache during hemodialysis (HDH) is prevalent but not negligible. Despite the high prevalence of dialysis headaches, they have rarely been studied. Therefore, this study aimed to evaluate the prevalence, risk factors, and clinical characteristics of HDH and reappraise the HDH diagnostic criteria in the International Classification of Headache Disorders 3 (ICHD-3). Methods One hundred and fifty-four patients completed this randomized cross-sectional study. Consecutive patients who underwent haemodialysis were assessed using a semi-structured questionnaire. The patients were administered face-to-face questionnaires while undergoing dialysis. Results This study included 154 patients. Before commencing dialysis, 3.24% (5/154) of the patients had migraine without aura, 1.29% (2/154) had menstrual-related migraine, 0.6% (1/154) had tension-type headaches, and 0.6% (1/154) had an unclassifiable headache. One case (0.6%) of headache resolved after dialysis treatment. HDH was diagnosed in 9.09% (14/154) of the patients. Headache after haemodialysis (HAH) was reported in 6.49% (10/154) of patients. The most prevalent features of HDH were frontal or temporal location, bilateral headaches, dull and throbbing nature, and moderate severity. HDH started at a mean of 2.33 ± 0.79 h after dialysis commenced. The average headache duration was 6.56 ± 1.57 h (median = 3.0 h), with 66.67% of the patients reporting a duration of ≤4 h. HDH was more prevalent in females than males (P = 0.01, P < 0.05). Female sex was a risk factor for HDH (P = 0.01，P < 0.05). Conclusions The diagnostic criteria for 10.2 HDH in ICHD-3 may miss several HAH. Therefore, ICHD-3 should be revised according to the literature and further studies.

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“…A recent study from Morocco suggested that renal replacement therapy like online hemodiafiltration gave superior results in terms of reduced incidence of HDH. [ 16 ] Further studies assessing how dialysis strategies can change frequency and severity of HDH would be required. We also evaluated the different modalities of treatment used by patients for treatment of HDH.…”

Section: Discussionmentioning

confidence: 99%

Headache Associated with Hemodialysis in Patients with End-Stage Renal Disease in India

Desai

Chhaya

Mankad

et al. 2022

Annals of Indian Academy of Neurology

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Background: Headache is a frequently encountered symptom among patients undergoing hemodialysis. Aim: The aim of this study was to elucidate the prevalence of hemodialysis associated headache (HDH), its possible etiology, its effect on the patients and steps taken in the management of the condition in Indian patients with end-stage renal disease (ESRD). Methods and Materials: A cross-sectional study was carried out amongst 128 consenting patients with ESRD on regular hemodialysis at a tertiary care medical teaching hospital over a period of 3 months to assess for prevalence of HDH and factors related to it. The pre hemodialysis serum electrolytes level, pre and post hemodialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Visual analogue scale (VAS) and patient health questionnaire-9 (PHQ9) was administered to the patients. t Test and Chi-square test were applied to find the association between HDH and various postulated factors and a regression analysis was performed. Results: Among 128 patients, 48 (37.5%) (men 18 [37.5%], women 30 [62.5%]) were found to have HDH. The mean headache severity scores on (VAS) was 4.5 ± 1.74. Patients having HDH had their mean PHQ9 scores 7.56 ± 4.51. Most patients had headaches in the first hour of dialysis and were located in the frontal and temporal part of the head. No statistically significant difference was found in the electrolyte levels between patients having HDH and without HDH. The headache was moderate in most but needed a paracetamol tablet to relieve the headache. Conclusion: Nearly one-third of patients undergoing dialysis have HDH, and it is associated with mild to moderate depression. The factors leading to HDH and its management need to be evaluated further to improve the quality of life of patients with ESRD on dialysis.

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Hemodialysis‐related headache: Still a challenge in 2020? Effect of conventional versus online hemodiafiltration from a study in Casablanca, Morocco

Cited by 7 publications

References 20 publications

Association of intradialysis blood sodium level, blood pressure variability, and hydration status with hemodialysis-related headache: a prospective cohort study

Association of intradialysis blood sodium level, blood pressure variability, and hydration status with hemodialysis-related headache: a prospective cohort study

The applicability research of the diagnostic criteria for 10.2 Heamodialysis-related headache in the international classification of headache disorders-3rd edition

Headache Associated with Hemodialysis in Patients with End-Stage Renal Disease in India

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