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10.2 Dialysis headache


Headache with no specific characteristics occurring during and caused by haemodialysis. It resolves spontaneously within 72 hours after the haemodialysis session has ended.

Diagnostic criteria:
  1. At least three episodes of acute headache fulfilling criterion C
  2. The patient is on haemodialysis
  3. Evidence of causation demonstrated by at least two of the following:
    1. each headache has developed during a session of haemodialysis
    2. either or both of the following:
      • a) each headache has worsened during the dialysis session
      • b) each headache has resolved within 72 hours after the end of the dialysis session
    3. headache episodes cease altogether after successful kidney transplantation and termination of haemodialysis
  4. Not better accounted for by another ICHD-3 diagnosis1.

Caffeine is rapidly removed by dialysis: 8.3.1 Caffeine-withdrawal headache should be considered in patients who consume large quantities of caffeine.


10.2 Dialysis headache commonly occurs in association with hypotension and dialysis disequilibrium syndrome. This syndrome may begin as headache and then progress to obtundation and finally coma, with or without seizures. It is relatively rare, and may be prevented by changing dialysis parameters.

Variations in urea, sodium and magnesium levels, and in blood pressure and body weight, may be risk factors for developing 10.2 Dialysis headache.