Intractable dialysis-associated headache: a management dilemma in pediatric hemodialysis.

Aviad Schnapp, Amir Shimonov, Ari Simckes, Adi Nitzan-Luques, Tal Gilboa, Oded Volovelsky

Abstract readCase Reports

In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Aviad SchnappPediatric Nephrology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. aviad.schnapp@hadassah.org.il.ORCID http://orcid.org/0000-0002-2127-3177

Amir ShimonovPediatric Nephrology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Ari SimckesPediatric Nephrology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Adi Nitzan-LuquesHemato-Oncology Department, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Tal GilboaNeuropediatric Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Oded VolovelskyPediatric Nephrology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. odedvo@hadassah.org.il.ORCID http://orcid.org/0000-0002-5378-1045

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dialysis-associated headache (DAH) is a common and recognized complication of chronic hemodialysis. We report a diagnostically challenging case of severe intradialytic headache in an adolescent with chronic kidney disease stage 5 and a history of ventriculoperitoneal shunt. A comprehensive evaluation excluded dialysis disequilibrium syndrome, biochemical and hemodynamic contributors, primary headache disorders, infection, vascular pathology, ophthalmologic causes, and shunt malfunction. Subsequent progression of focal neurological findings revealed a diffuse intramedullary spinal cord glioma. This case highlights the limitations of solely attributing refractory DAH to dialysis-related etiologies and underscores the importance of repeated neurological reassessment and multidisciplinary management in pediatric dialysis patients.

Indexed as

GliomaHeadacheKidney Failure, ChronicRenal DialysisSpinal Cord NeoplasmsAdolescentHumansMagnetic Resonance ImagingMaleVentriculoperitoneal ShuntChronic kidney diseaseDiagnostic delayPediatric hemodialysisRefractory dialysis-associated headacheSpinal cord glioma

Identifiers

PMID41874688

DOI10.1007/s00467-026-07281-y

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