Dialysis headache: A literature review in the last 30 years





Dialysis headache, Hemodialysis, Dialysis, Clinical features, Prevalence



According to the International Classification of Headache Disorders (ICHD-3), dialysis headache has no specific characteristics occurring during and caused by haemodialysis. It resolves spontaneously within 72 hours after the haemodialysis session has ended.


To describe the prevalence, clinical features, associated symptoms and risk factors of dialysis headache.


Based on a literature search in the major medical databases and using the descriptors“dialysis headache”, “hemodialysis and headache” and “renal dialysis and headache”we included articles published between 1992 and 2022. Of the 492articles found, only 9 met the inclusion criteria and were analyzed.


We describe 444 patients (53.1% men and 46.9% women) diagnosed with dialysis headache, corresponding to 24.8% of those who underwent hemodialysis.The age ranged from 15 to 75 years. Pain occurred predominantly from the third hour of hemodialysis (65.8%), lasting less than four hours (71.7%), located bilaterally (63.1%), pulsatile (58.5%) and moderate intensity (68.9%).The most frequent associated symptoms were photophobia or phonophobia (71.5%), vertigo (22.3%) and nausea and/or vomiting (16.5%).


This review showed a high prevalence of dialysis headache in patients undergoing hemodialysis and that the clinical characteristics, treatment and prevention are still poorly studied.


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Stojimirovic B, Milinkovic M, Zidverc-Trajkovic J, Trbojevic-Stankovic J, Maric I, Milic M,…Nikic P. Dialysis headache in patients undergoing peritoneal dialysis and hemodialysis. Ren Fail 2015;37(2):241-244 Doi:10.3109/0886022X.2014.982486. DOI: https://doi.org/10.3109/0886022X.2014.982486

Santos KALM, Martins HAL, Ribas VR and Valença MM. Cefaleia relacionada à hemodiálise: História prévia de cefaleia é um fator de risco. Migrâneas cefaleias 2009;12(3):112-114.

Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1-211 Doi:10.1177/0333102417738202. DOI: https://doi.org/10.1177/0333102417738202

Antoniazzi AL, Bigal ME, Bordini CA and Speciali JG. Headache associated with dialysis: the International Headache Society Criteria revisited. Cephalalgia 2003;23:146-149 Doi:10.1046/j.1468-2982.2003.00510.x. DOI: https://doi.org/10.1046/j.1468-2982.2003.00510.x

Antoniazzi AL, Bigal ME, Bordini CA, Tepper SJ and Speciali JG. Headache and hemodialysis: a prospective study. Headache 2003;43(2):99-102 Doi:10.1046/j.1526-4610.2003.03025.x. DOI: https://doi.org/10.1046/j.1526-4610.2003.03025.x

Göksan B, Karaali-Savrun F, Ertan S and Savrun M. Haemodialysis-related headache. Cephalalgia 2004;24(4):284-287 Doi:10.1111/j.1468-2982.2004.00668.x. DOI: https://doi.org/10.1111/j.1468-2982.2004.00668.x

Goksel BK, Torun D, Karaca S, Karatas M, Tan M, SezginN,…Ozdemir N. Is low blood magnesium level associated with hemodialysis headache? Headache 2006;46(1):40-45 Doi:10.1111/j.1526-4610.2006.00295.x. DOI: https://doi.org/10.1111/j.1526-4610.2006.00295.x

Melo ES, Aguiar FC, Rocha-Filho PAS. Dialysis headache: A narrative review. Headache. 2016;57(1):161-164 Doi: 10.1111/head.12875. DOI: https://doi.org/10.1111/head.12875

Melo ES, Pedrosa RP, Aguiar FC, Valente LM and Rocha-Filho PAS. Dialysis headache: characteristics, impact and cerebrovascular evaluation. Arq Neuropsiquiatr 2022;80(2):129-136 Doi:10.1590/0004-282X-ANP-2021-0133. DOI: https://doi.org/10.1590/0004-282x-anp-2021-0133

Sav MY, Sav T, Senocak E and Sav NM. Hemodialysis-related headache. Hemodial Int 2014;18(4):725-729 Doi:10.1111/hdi.12171. DOI: https://doi.org/10.1111/hdi.12171

Alessandri M, Massanti L, Geppetti P, Bellucci G, Cipriani M and Fanciullacci M. Plasma changes of calcitonin gene-related peptide and substance P in patients with dialysis headache. Cephalalgia 2006;26(11):1287-1293 Doi:10.1111/j.1468-2982.2006.01217.x. DOI: https://doi.org/10.1111/j.1468-2982.2006.01217.x

Chhaya KT, Mankad S, Shah MK, Patel M, Desai D and Desai SD. Headache Associated with Hemodialysis in Patients with End-Stage Renal Disease in India: A Common Yet Overlooked Comorbidity. Ann Indian Acad Neurol 2022;25(1):82-87 Doi:10.4103/aian.aian_404_21. DOI: https://doi.org/10.4103/aian.aian_404_21

Gozubatik-Celik G, Uluduz D, Goksan B, Akkaya N, Sohtaoglu M, Uygunoglu U,… Siva A. Hemodialysis-related headache and how to prevent it. Eur J Neurol 2019;26(1):100-105 Doi:10.1111/ene.13777. DOI: https://doi.org/10.1111/ene.13777

Moraes AP, Salomão CEM, Soares FHC, Sousa KS, Moraes TC, Silva MH, ... Jurno ME. Prevalência de cefaleia em uma unidade de diálise. Rev Interdisciplin Estud Exp 2016;8:23-30.

Jesus AC, Oliveira HA, Paixão MO, Fraga TP, Barreto FJ and Valença MM. Clinical description of hemodialysis headache in end-stage renal disease patients. Arq Neuropsiquiatr 2009;67(4):978-981 Doi:10.1590/s0004-282x2009000600003. DOI: https://doi.org/10.1590/S0004-282X2009000600003

Hazim A, Adarmouch L, Eloury A, Aasfara J, Asly M and Slassi I. Hemodialysis-related headache: Still a challenge in 2020? Effect of conventional versus online hemodiafiltration from a study in Casablanca, Morocco. Artif Organs 2021;45(6):602-607 Doi:10.1111/aor.13886. DOI: https://doi.org/10.1111/aor.13886

Nerbass FB, Lima HDN, Thomé FS, Vieira Neto OM, Lugon JR and Sesso R. Brazilian Dialysis Survey 2020. J BrasNefrol. 2022;23:1-9 Doi:10.1590/2175-8239-JBN-2021-0198. DOI: https://doi.org/10.1590/2175-8239-jbn-2022-0083en

Mehmood Y, Ghafoor S, Ashraf MI, Riaz H, Atif SR and Saeed M. Intradialytic complications found in patients at a tertiary care hospital. Austin J PharmacolTher 2016;4(1):1-5.

Prabhakar, Singh RG, Singh S, Rathore SS and Choudhary TA. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience. Saudi J Kidney Dis Transpl 2015;26(1):168-172 Doi:10.4103/1319-2442.148771. DOI: https://doi.org/10.4103/1319-2442.148771

Wang Y, Wang S, Qiu T and Xiao Z. Photophobia in headache disorders: characteristics and potential mechanisms. J Neurol 2022;23 Doi:10.1007/s00415-022-11080-4. DOI: https://doi.org/10.1007/s00415-022-11080-4

Kalita, J,Misra, UK and Bansal, R. Phonophobia and brainstem excitability in migraine. Eur J Neurosci 2021;53:1988-1997 Doi:10.1111/ejn.15078. DOI: https://doi.org/10.1111/ejn.15078




How to Cite

Souza M, Lima KR, Fortes YML, Silva-Neto R, Filgueiras MC. Dialysis headache: A literature review in the last 30 years. Headache Med [Internet]. 2022 Dec. 28 [cited 2024 Mar. 2];13(4):237-41. Available from: https://headachemedicine.com.br/index.php/hm/article/view/665




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