Dialysis Side Effects: How to Deal

Kidney disease is the 8th leading cause of death in the United States. Today an estimated 31 million Americans are living with chronic kidney disease, and nearly 350,000 receive life-saving treatment through dialysis. For those with end-stage kidney disease (ESKD), dialysis helps discharge accumulated toxins from the bloodstream. While this replacement therapy can extend life, both peritoneal dialysis and hemodialysis produce certain physical side effects.

If you or a loved one is undergoing kidney dialysis, here are the 6 most common side effects to be aware of: 

1. Low blood pressure – When extra fluid is removed from the body during dialysis, it results in low blood pressure, including nausea and dizziness. The most common side effect of dialysis– it affects one fourth of all patients. Patients can help manage blood pressure drops by limiting fluid intake before dialysis treatment.  If you have fluid load in the body, notify the dialysis team before you start and they can adjust the dialyzing time accordingly. Medications can also produce low blood pressure, so consult your physician about whether it’s safe to avoid taking medicines before treatment.
2. Nausea and vomiting – High urea levels in the blood as a result of kidney disease cause nausea and vomiting. These side effects are exacerbated by low blood pressure and excess fluid weight gain. Your healthcare professional can adjust the treatment according if you experience symptoms, or your doctor may prescribes anti-nausea medication to help.
3. Muscle cramps – If fluid is extracted too quickly from the body, muscles react by cramping. Muscle cramps, usually in the legs, can be very uncomfortable and sometime painful for dialysis patients. Notify the dialysis team immediately if cramping results. A doctor may recommend applying heat to the affected area or massage to stimulate circulation.
4. Restless leg syndrome – Restless leg syndrome, a disorder that causes the legs to shake and move, is another common side effect of dialysis. It has been tied to kidney disease, diabetes, hardening of arteries, and vitamin B deficiency. Speak with your doctor to identify the specific cause.
5. Dry, itchy skin – Dry skin is a common side complaint of dialysis patients, particularly during winter months. The side effect is linked to an excess of phosphorous in the body. Dry skin can be managed by sticking to a low-phosphorous renal diet. Avoid taking very hot baths and take care to use basic moisturizing lotions and creams.
6. Infection – Pressure on the access (from clothing, sleeping) can cause the site to become irritated. If an access becomes clotted with blood, the patient will not receive treatment. Dialysis patients should take extra care to ensure the point of access is clean and clear of any redness or itching. Check the access daily to confirm the “thrill” (the pulse feeling in the fistula or graft) is flowing properly.

During the dialysis treatment process, it is critical to keep an open line of communication with your healthcare provider. Day-to-day fluctuations in symptoms, side effects, and reactions can be indicators of health, and are easier to document and manage than ever before with the aid of technology.

Have you had experience caring for someone on dialysis? What other side effects should one be aware of?