Dialysis-associated seizures in children and adolescents.

A retrospective medical chart review was conducted to document seizure occurrence in 180 children and adolescents (newborn to 22 years of age) receiving hemodialysis (HD) and/or peritoneal dialysis (PD) from January 1974 through June 1988 at Children's Hospital and Medical Center in Seattle, Washington. The purpose of the review was to identify risk factors associated with seizure activity during or up to 24 h following dialysis treatment. Seventy-eight patients received only HD, 79 received only PD and 23 received both HD and PD. Dialysis-associated seizures (DAS) were seen in 7.2% (13/180) of all dialyzed patients; 12 occurred during HD and 1 occurred during PD. Patients receiving only HD were more likely to experience DAS (7/78, 9%), than patients receiving only PD (0/79, 0%) (chi-squared = 5.5, 1 df, P = 0.02). Among the 101 patients who received HD, the risk of HD-associated seizures among those with a prior history of seizure (6/21, 29%) was significantly higher than among those with no history of seizure (6/80, 8%) (chi-squared = 5.2, 1 df, P = 0.02). Prior history of seizure did not influence the risk of seizures among patients receiving PD. These data suggest that patients receiving HD, and especially those with a prior history of seizure, should be monitored closely during dialysis and measures taken to reduce the risk of seizures.