To reduce the risk of dialysis disequilibrium syndrome in high BUN patients, clinicians often use:

• A. Higher dialysate temperature
• B. Longer, slower dialysis sessions
• C. Shorter, more frequent dialysis sessions
• D. Higher blood flow rate

Answer: (C)

Preventing rapid shifts in blood osmolality is the main idea. Dialysis disequilibrium syndrome happens when urea and other solutes are removed from the blood too quickly, creating an osmotic gradient that pulls water into the brain and can cause cerebral edema. Using shorter, more frequent dialysis sessions slows the rate at which solutes are cleared each time and distributes removal over several treatments. This gentler approach allows brain and extracellular compartments to re-equilibrate gradually, reducing the risk of DDS while still achieving overall toxin removal over time. Options that would increase the rate of solute removal or alter conditions in ways that don’t directly address the osmolar shift are less effective at preventing DDS; the emphasis is on avoiding a rapid drop in plasma osmolality by keeping sessions shorter and more frequent.