Dialysis disequilibrium syndrome: a consideration in patients with hydrocephalus.

Dialysis disequilibrium syndrome is a rare neurological manifestation of intermittent hemodialysis. Urea removal occurs more slowly across the blood-brain barrier than from the plasma, generating an osmotic gradient that promotes water movement into the brain and cerebral edema. The authors report the development of dialysis disequilibrium syndrome in a patient with spina bifida and an adequately functioning shunt.