What You Need to Know About Dialysis Side Effects

What are the types of dialysis?

Dialysis is a medical procedure that helps people with low kidney function filter and purify their blood. Kidney failure is the most common underlying condition that requires dialysis.

There are three types of dialysis.

• Hemodialysis (HD): uses a machine called a hemodialyzer to filter waste from your blood. The hemodialyzer functions as an artificial kidney, removing blood, cleaning it, and filtering it back into the body.
• Peritoneal dialysis (PD): uses filtration fluid inside your abdominal (peritoneal) cavity to filter and clean your blood. This fluid, called dialysate, is positioned inside your abdominal cavity and directly absorbs waste from your blood as it circulates.
• Continuous renal replacement therapy (CRRT): uses a machine to filter waste from your blood. This therapy (hemofiltration) is generally reserved for acute kidney injury or people with end stage renal disease (ESRD) and is only performed in a hospital setting.

What are the side effects of dialysis?

The most common side effect of all dialysis procedures is fatigue. Other side effects and complications by type of dialysis include:

Hemodialysis

• Low blood pressure: Low blood pressure (hypotension) during HD occurs due to the temporary loss of fluids during treatment. If your blood pressure drops during treatment, you may also notice dizziness, nausea, clammy skin, and blurry vision.
• Muscle cramps: Muscle cramps may occur during dialysis due to a change in fluid or mineral balance. Low levels of sodium, magnesium, calcium, and potassium can all contribute to muscle cramping.
• Itchy skin: Waste products may accumulate in your blood between HD sessions, leading to itchy skin. If the itchiness is primarily in your legs, it could also be due to restless legs syndrome.
• Blood clots: Clots may occur in your fistula due to narrowing, which an angiogram can fix. It can lead to swelling. Differently, people with ESRD are more likely to have clots such as deep vein thrombosis.
• Infection: Frequent needle insertion during dialysis increases your exposureTrusted Source to bacteria. Individuals on dialysis with tunneled dialysis catheters are at the highest risk for infections, including bacteremia, which can lead to sepsis.
• Other side effects: Other risks and side effects of HD may include difficulty sleeping or weakness. Cardiac arrest is a severe complication. Many of these side effects are due to the fluid and mineral imbalances that dialysis may cause.

Peritoneal dialysis

Other than the risk of infection, common PD side effects and complications differ slightly from those of HD.

• Peritonitis: Peritonitis is a bacterial infection of your peritoneum (membrane lining your abdominal cavity and organs) that may occur because of catheter insertion or usage. Symptoms may include abdominal pain, tenderness, bloating, nausea, and diarrhea.
• Hernia: A hernia happens when an organ or fatty tissue pushes through an opening in your muscle. People who receive PD are at risk for developing an abdominal hernia because dialysate places extra pressure on their abdominal wall. The most common symptom is a small abdominal lump.
• High blood sugar: Dialysate contains dextrose, a sugar commonly used during intravenous nutrition. Sugars like dextrose raise blood sugar, which may put people with diabetes who need PD at risk for hyperglycemia. An icodextrin solution (dextrose free) is available for those with hyperglycemia.
• Weight gain: Weight gain may occur due to the additional calories from the administration of dialysate. However, other factors, such as lack of exercise and nutrition, may also impact weight gain during dialysis.
• Other side effects: The stress and anxiety of constant medical procedures may lead to depression. Research from 2018 suggests a link between dialysis and dementia in older adults.

Continuous renal replacement therapy

Research from 2019 suggests that common complications of CRRT may include:

• circuit clotting from inadequate catheter function
• low phosphorus levels (hypophosphatemia)
• drop in body temperature
• low blood pressure
• additional electrolyte abnormalities

When to contact your doctor

Keep your care team in the loop about anything you may be experiencing. Seek medical care right away if you experience any of the following during or after dialysis treatment:

• difficulty breathing
• confusion or trouble concentrating
• pain, redness, or swelling in your limbs
• fever above 101°F (38ºC)
• loss of consciousness

These symptoms may be associated with hypotension, hyperglycemia, blood clots, or severe infection and require immediate treatment.

Is there treatment for dialysis side effects?

A registered dietitian can provide appropriate dietary recommendations, including what to eat and avoid.

At home you can minimize your risk of dialysis side effects by:

• checking your access site frequently, which can help to minimize infection risk.
• exercising regularly, such as low to moderate aerobic exercise, to help manage weight.
• having more frequent dialysis sessions, which research has shown may reduce the risk of low blood pressure and weight gain
• enjoying your favorite activities, which may improve your mood throughout treatment.

What’s the outlook for people with side effects from dialysis?

If you have kidney failure and your kidneys no longer function, you may require lifelong dialysis. This means that you may experience dialysis side effects daily.

You can, however, still live a full life by managing your side effects with the help of your care team.

Takeaway

Common side effects of hemodialysis may include low blood pressure, access site infection, muscle cramps, itchy skin, or blood clots.

Common side effects of peritoneal dialysis may include peritonitis, hernia, blood sugar changes, low potassium, or weight gain.

Continuous renal replacement therapy may commonly cause circuit clotting from inadequate catheter function, low phosphate levels, a drop in body temperature (can also occur in hemodialysis), or low blood pressure.

Report any dialysis side effects, complications, or symptoms to your care team immediately. They can help you manage and treat them.