Classically, DDS arises in individuals starting hemodialysis due to chronic renal failure and is associated, in particular, with "aggressive" (high solute removal) dialysis. However, it may also arise in fast onset, i.e. acute, renal failure in certain conditions.
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 resulting 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.
MRI of the head has been used in research to better understand DDS.
Dialysis Disequilibrium Syndrome: Rapid Recognition and Rapid Intervention Decrease the Risk of Mortality a Case Study
Jul 01, 2013; The Case A 24-year-old female with a past history of poorly controlled insulin-dependent diabetes and lupus presented to the...