Hemodialysis related headache is prevelent in nearly one third of patients, predominent in males presented to hemodialysis session, evident from a recent study published in the 'European Journal of Neurology'. This form of headache is associated with serum BUN levels and blood pressure differences between the pre - and post -dialysis periods. 

Hemodialysis (HD) may affect the nervous system adversely. The most common reported neurological symptom among HD-patients is the headache. Headche associated with hemodialysis is characterized as primarily bilateral, and either throbbing or dull, with moderate severity.

Gozubatik-Celik G et al. performed this study to reveal the frequency, clinical characteristics, activating factors of an HD-related headache (HRH) and to assess the preventive techniques for reducing the HRH. 

All in all, 494 patients were involved in this study. The comparative controls (CC) were classified within the same patients without a headache. Before/after HD the arterial systolic-diastolic-blood pressure, BUN, creatinine were correlated. During the dialysis, the urea reduction ratio was also calculated.  

 One hundred and seventy-five patients (35.4%) with a mean age of 57.3±15.7 years were diagnosed with HRH. HRH was more recurrent in males. After the HD, the headache started with a mean of 2.90±0.86 hours. Bi-frontal localization of pain was observed in 41.7% of patients (n=73). Mean duration of a headache was 6.22±7.8 h and 60% duration of ≤ 4 h described by 64.0% patients. Mean VAS-score was 5.64±2.05. Differences between pre\post-dialysis BUN values were reported to be 94.6 ± 31.1 in HRH pt. and 86.8±28.5 in the CC group. The difference between systolic blood pressure of pre\post-dialysis measurements was 22.4±16.5 mmHg in HRH pt.; 12.8±19.4 mmHg in CC. Significantly higher mean systolic and diastolic blood pressure pre-dialysis values were observed in patients with HRH (systolic, p=0.002; diastolic, p<0.001). HRH group reported higher differences in systolic\diastolic blood pressure between pre\post-dialysis.

Thus, HRH can be prevented by screening for high blood pressure and serum BUN levels prior to dialysis.