Antoniazzi Ana L, Bigal Marcelo E, Bordini Carlos A, Tepper Stewart J, Speciali José G
Department of Neurology, School of Medicine at Ribeirão Preto, São Paulo University, Brazil.
Headache. 2003 Feb;43(2):99-102. doi: 10.1046/j.1526-4610.2003.03025.x.
To determine the prevalence and clinical characteristics of headache in patients undergoing hemodialysis and to compare the prevalence of headache prior to and following the beginning of a hemodialysis program.
About 70% of patients receiving hemodialysis complain of headache. Despite this, headaches have not been well studied in this group of patients.
We evaluated a series of patients with chronic renal failure who attended 3 hemodialysis services in a Brazilian town from January of 1998 to December of 1999. Patients with headache were prospectively followed and classified according to the International Headache Society criteria. The headaches were also categorized according to their temporal profile relative to hemodialysis.
Headache was reported by 87 (70.7%) of the 123 patients studied. Prior to beginning dialysis, 48% had migraine, 19% had episodic tension-type headache, and 8% had both. Headache related to arterial hypertension was the second most frequent headache diagnosis in these patients (25.4%). Fifty patients (57.5%) experienced headache during the session of hemodialysis. Thirty-four were classified as dialysis headache, 7 were classified as migraine, 7 as episodic tension-type headache, and 2 were unclassified. Twenty-four patients (27.6%) reported dramatic improvement of their headaches after the beginning of the dialysis program.
Headache is common in patients undergoing hemodialysis. Classification of such headaches according to the International Headache society criteria may be difficult.
确定接受血液透析患者头痛的患病率及临床特征，并比较血液透析治疗开始前后头痛的患病率。
约70%接受血液透析的患者主诉头痛。尽管如此，该组患者的头痛情况尚未得到充分研究。
我们评估了1998年1月至1999年12月期间在巴西一个城镇的3家血液透析机构就诊的一系列慢性肾衰竭患者。对有头痛的患者进行前瞻性随访，并根据国际头痛协会标准进行分类。头痛还根据其与血液透析的时间关系进行分类。
在研究的123例患者中，87例（70.7%）报告有头痛。在开始透析前，48%患有偏头痛，19%患有发作性紧张型头痛，8%两者都有。与动脉高血压相关的头痛是这些患者中第二常见的头痛诊断（25.4%）。50例患者（57.5%）在血液透析过程中出现头痛。34例被分类为透析性头痛，7例为偏头痛，7例为发作性紧张型头痛，2例未分类。24例患者（27.6%）报告在透析治疗开始后头痛明显改善。
头痛在接受血液透析的患者中很常见。根据国际头痛协会标准对这类头痛进行分类可能有困难。
