Headaches During Hemodialysis: A Neglected Yet Prevalent Syndrome

Background Headache is a frequently reported symptom among hemodialysis (HD) patients, with 28–73% experiencing dialysis-related headaches (DH). Despite its high prevalence, DH remains under-recognised and poorly understood. Various factors such as changes in blood pressure, electrolyte imbalances, and dialysate composition have been implicated in its pathophysiology. The present study aimed to assess the frequency and clinical characteristics of dialysis headache in HD patients. Materials & Methods A prospective observational study was conducted on 102 HD patients at a tertiary care centre in South India. Patient data were collected using a standardised questionnaire based on ICHD criteria. Blood samples were drawn pre-heparinization for biochemical analysis. Headache characteristics were documented, and statistical analyses were conducted using t-tests, chi-square, and correlation methods, with p < 0.05 considered significant. Results The mean age was 53.4 ± 13.5 years; 59.8% were male. Most patients (63.7%) underwent dialysis thrice weekly. Headache was reported by 28.4% during dialysis, commonly in the temporal region and mostly in the final hour of treatment. The most frequent headache severity scores were 4 and 5. Systolic blood pressure during headache episodes showed a significant positive correlation with headache severity (r = 0.202, p = 0.042). No significant associations were found with serum sodium, potassium, or DBP. Conclusion Dialysis headache is common and often correlates with elevated intradialytic SBP. Monitoring and managing intradialytic hemodynamics may help alleviate DH.