Dialysis is a lifesaving treatment for people with kidney failure. When you begin dialysis, you may experience side effects such as low blood pressure, mineral imbalances, blood clots, infections, weight gain, and more.
Your care team can help you manage most dialysis side effects so they don’t lead to long-term complications.
In this article, we’ll explore the side effects of dialysis, including why they happen and how to alleviate them during treatment.
Dialysis is a medical procedure to help people with low kidney function filter and purify their blood. The most common underlying condition that requires dialysis is kidney failure. There are three types of dialysis.
Hemodialysis uses a machine called a hemodialyzer to filter waste from the blood.
Before starting hemodialysis, an access port is created somewhere on the body, such as the arm or neck. This access point is then connected to the hemodialyzer, which functions as an artificial kidney to remove the blood, clean it, and filter it back into the body.
Peritoneal dialysis requires surgical placement of an abdominal catheter. The process uses a filtration fluid inside the abdominal cavity to filter and clean the blood. This fluid, called dialysate, is positioned inside the peritoneal cavity and directly absorbs waste from the blood as it circulates.
Once the fluid has performed its job, it can be drained and discarded, and the procedure can begin again.
Peritoneal dialysis can be done in your home and is sometimes performed overnight while you’re sleeping.
Continuous renal replacement therapy (CRRT)
Continuous renal replacement therapy, also known as hemofiltration, also uses a machine is used to filter waste from the blood.
This therapy, generally reserved for acute kidney failure caused by certain underlying medical conditions, is only performed in a hospital setting.
For most people with kidney failure, dialysis is a necessary procedure. However, there are risks and side effects that accompany this treatment.
The most common side effect of all dialysis procedures is fatigue. Other side effects by type of treatment include:
- Low blood pressure. Low blood pressure, or hypotension, during hemodialysis 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 can occur during dialysis due to a change in fluid or mineral balance. Low levels of sodium, magnesium, calcium, and potassium can all play a role in muscle cramping.
- Itchy skin. Between hemodialysis sessions, waste products can begin to accumulate in the blood. For some people, this can lead to itchy skin. If the itchiness is primarily in the legs, it could also be due to restless legs syndrome.
- Blood clots. Sometimes, installing an access point leads to narrowing of the blood vessels. If left untreated, this can cause swelling in the upper half of the body or even blood clots.
- Infection. Frequent insertion of needles or catheters during dialysis can increase exposure to bacteria. If bacteria enter the bloodstream during treatment, you may be at risk for infection or even sepsis. Without immediate treatment, sepsis can lead to death.
- Other side effects. Other risks and side effects of hemodialysis may include anemia, difficult sleeping, heart conditions, or cardiac arrest. Many of these side effects are due to the fluid and mineral imbalances that dialysis can cause.
Other than the risk of infection, common peritoneal dialysis side effects are slightly different from those of hemodialysis.
- Peritonitis. Peritonitis is an infection of the peritoneum that happens if bacteria enters the peritoneum during catheter insertion or usage. The symptoms of peritonitis may include abdominal pain, tenderness, bloating, nausea, and diarrhea.
- Hernia. A hernia happens when an organ or fatty tissue pushes through an opening in the muscle. People who receive peritoneal dialysis are at risk of developing an abdominal hernia because dialysate places extra pressure on the abdominal wall. The most common symptom is a small abdominal lump.
- High blood sugar. Dialysate contains a sugar called dextrose, which is commonly used during intravenous nutrition. Sugars like dextrose raise blood sugar, which may place people with diabetes who need peritoneal dialysis at risk for hyperglycemia.
- High potassium. High potassium, known as hyperkalemia, is a common side effect of kidney failure. Between dialysis sessions, your potassium levels can build up due to lack of proper filtration.
- Weight gain. Weight gain may also occur due to the additional calories from the administration of dialysate. However, there are a variety of other factors that can also impact weight gain during dialysis, such as lack of exercise and nutrition.
- Other side effects. For some people, the stress and anxiety of constant medical procedures can lead to depression. Research has also suggested a possible link between dialysis and dementia later in life.
Continuous renal replacement therapy (CRRT)
The side effects of CRRT haven’t been as extensively studied as those caused by other types. One
Many of the side effects of dialysis, including low blood pressure and other heart conditions, happen because of nutrient imbalances during treatment. A registered dietitian can provide appropriate dietary recommendations, including what to eat and what to avoid.
Other things you can do at home to minimize the risk of dialysis side effects include:
- checking your access site frequently, which can help to minimize infection risk
- getting enough exercise, such as low to moderate aerobic exercise, which can help reduce weight gain
- drinking water or liquids according to your healthcare provider’s instructions, which can reduce dehydration
- having more frequent dialysis sessions, which
researchhas shown may reduce the risk of low blood pressure and weight gain
- enjoying your favorite activities, which can up your mood throughout treatment
When to call your doctor
Although dialysis side effects are incredibly common, it’s important to 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 symptoms during or after dialysis treatment:
- difficulty breathing
- confusion or trouble concentrating
- pain, redness, or swelling in the limbs
- fever above 101°F
- loss of consciousness
These symptoms may be associated with hypotension, hyperglycemia, blood clots, or severe infection and require immediate treatment.
If you have kidney failure and your kidneys no longer function, you may require lifelong dialysis. This means that you may experience the symptoms of dialysis on a frequent basis. However, you can still live a full life by managing your symptoms with the help of your care team.
The most common side effects of hemodialysis include low blood pressure, access site infection, muscle cramps, itchy skin, and blood clots. The most common side effects of peritoneal dialysis include peritonitis, hernia, blood sugar changes, potassium imbalances, and weight gain.
Report any symptoms you experience during treatment to your care team. They can help you manage them with dietary and lifestyle changes.
If you notice any symptoms of extremely low blood pressure, high blood sugar, blood clots, or a spreading infection, you should seek medical attention immediately.