Clinical description of hemodialysis headache in end-stage renal disease patients.

Background: Hemodialysis (HD)-related headaches are a common complaint of patients undergoing this procedure.

Objective: To determine the frequency and clinical characteristics of headache in patients undergoing HD and to discuss their diagnostic criteria.

Method: The present study assessed, in a prospective manner, a series of patients consulting at a HD center in Aracaju, Sergipe, Brazil, from November 2007 to January 2008. Only patients with HD-related headaches without previous history of primary headache were diagnosed as isolated HD headache (HDH).

Results: Headache was reported by 76.1% of the patients studied. Prior to beginning dialysis, 47.9% had migraine without aura, 6.7% migraine with aura, 0.6% hemiplegic migraine, 5% episodic tension-type headache, and 2.5% migraine and tension-type headache. HDH was diagnosed in 6.7% of the patients, the most prevalent features being diffuse or temporal region location, bilateral headache, throbbing nature, and moderate severity. Seven patients with headaches between the sessions were not classified.

Conclusion: While the pathophysiology of HDH is unknown, to diagnose patients with HDH or other possible HD-related headaches remains a challenge.