Kidneys are vital organs in the human body and dialysis is a medical procedure that substitutes the natural functions of kidneys. Typically this procedure is recommended to patients who are suffering from any kidney-related issues and their kidney function drops to below 10-15% of the normal capacity. Conditions like chronic kidney disease and acute kidney failure are two of the most common conditions that make it mandatory for patients to opt for dialysis treatments. Some of the other key causes also include diabetes, high blood pressure glomerulonephritis, and polycystic kidney disease. Whatever the condition, dialysis treatment can significantly improve the overall well-being of the patients by performing all the vital functions of the kidneys. However, there are multiple complications of dialysis, that can impact the effectiveness of dialysis treatment. This guide discusses all the common complications during kidney dialysis and also provides guidance on how to manage them.
Who Needs Dialysis?
- Individuals experiencing end-stage renal disease (ESRD) or significant kidney impairment.
- Short-term dialysis might be necessary for acute kidney injury (AKI) until kidney function improves.
- Doctors assess factors like glomerular filtration rate (GFR), symptoms of uremia (e.g., nausea, confusion), and fluid overload.
Types of kidney dialysis and How dialysis works
Before understanding the dialysis complications and management, it is important to understand the different types of dialysis and how the dialysis actually works. Each dialysis treatment works differently and hence has different complications associated with it. Here are the different types of kidney dialysis:
1. Hemodialysis
In this dialysis treatment procedure, the blood is filtered outside the body using a machine and then it is pumped into the body after cleaning it from the toxins. These are usually performed in the clinic and typically 3-4 times a week, with each session lasting upto 4-5 hours approximately based on the patient’s condition.
2. Peritoneal dialysis
Peritoneal dialysis uses the lining of the abdomen of the patient to filter blood inside the body itself. However there are two types of peritoneal dialysis,
Continuous ambulatory peritoneal dialysis (CAPD)
The fluid exchange between the body and the machine is manual and is performed several times a day.
Automated peritoneal dialysis (APD)
The machine takes of the fluid exchange automatically without any human interference, and is performed usually at night while the patient is sleeping.
Benefits of Dialysis
- Removes waste products, toxins, and excess fluid.
- Helps control blood pressure.
- Improves quality of life and extends life expectancy for patients with kidney failure.
Complications during dialysis
There are various dialysis patient complications depending on the type of dialysis opted. Let us discuss some of the most commonly experienced complications by patients.
1. Low Blood Pressure (Hypotension)
- Cause : Rapid removal of fluid or imbalance in electrolytes during dialysis.
- Symptoms : Dizziness, nausea, fainting, or blurred vision.
- Management :
- Reduce the fluid removal rate during dialysis.
- Administer saline infusions as needed.
- Pre-dialysis hydration and regular monitoring of blood pressure.
2. Muscle Cramps
- Cause : Rapid shifts in fluid and electrolytes.
- Symptoms : Painful contractions in the legs or arms during dialysis.
- Management :
- Adjust dialysis settings to reduce fluid removal rate.
- Stretching, massage, or warm compresses.
- Electrolyte supplementation if necessary.
3. Infections at AccessSite
- Cause : Bacterial contamination of the vascular access (fistula, graft, or catheter).
- Symptoms : Redness, swelling, warmth, or pus at the access site.
- Management :
- Maintain strict hygiene and proper sterilization techniques.
- Use of antibiotics to treat infections.
- Replace the infected access if necessary.
4. Blood Clotting in Access
- Cause :Poor blood flow or improper use of vascular access is one of the post dialysis complications
- Management :
- Use anticoagulants like heparin during dialysis.
- Surgical or radiological intervention to remove clots.
5. Nausea and Vomiting
- Cause :Uremia or rapid changes in blood chemistry.
- Management :
- Adjust the dialysis duration and settings.
- Prescribe anti-nausea medications.
6. Dialyzer Reactions
- Cause :Allergic reaction to the dialyzer membrane.
- Symptoms : Itching, fever, or shortness of breath.
- Dialysis management :
- Use biocompatible dialyzers.
- Administer antihistamines or corticosteroids as required.
- Peritoneal Dialysis Complications
7. Peritonitis (Abdominal Infection)
- Cause : Contamination of the catheter or dialysate.
- Symptoms : Fever, abdominal pain, cloudy dialysate.
- Management :
- Immediate antibiotic treatment (intraperitoneal or intravenous).
- Adherence to aseptic techniques during exchanges.
8. Catheter Blockage or Malfunction
- Cause : Fibrin, clot formation, or mechanical issues.
- Symptoms : Reduced dialysate flow or no drainage.
- Management :
- Flush the catheter with heparinized solution.
- Surgical repositioning or replacement if needed.
9. Hernias
- Cause : Increased abdominal pressure from dialysate.
- Symptoms : Bulging or discomfort in the abdomen.
- Management :
- Surgical repair.
- Reduce dialysate volume to minimize pressure.
10. Weight Gain
- Cause : Absorption of glucose from the dialysate.
- Management :
- Monitor caloric intake and increase physical activity.
- Use low-glucose dialysate solutions.
11. Leaks Around Catheter Site
- Cause : Poor healing or high pressure from dialysate.
- Management :
- Allow time for healing by temporarily halting exchanges.
- Adjust fluid volumes or reposition catheter if necessary.
12. Fatigue
- Cause : Physical and emotional strain of treatment.
- Management :
- Ensure adequate rest.
- Follow a balanced diet rich in energy-boosting nutrients.
- Light physical activity like walking or yoga.
13. Electrolyte Imbalance
- Cause : Over or under-removal of electrolytes like potassium or calcium.
- Symptoms :Muscle weakness, irregular heartbeats, or confusion.
- Management :
- Regular blood tests to monitor levels.
- Tailored dialysis plans and dietary adjustments.
14. Emotional and Mental Health Challenges
- Cause : Stress from lifestyle changes and dependency on treatment.
- Management :
- Seek support from counsellors or support groups.
- Practice mindfulness, meditation, or hobbies to reduce stress.
- Seek support from counsellors or support groups.
Common Challenges Across Dialysis Types
1. Fatigue
- Cause : Physical toll of the procedure.
- Management : Adequate rest, balanced nutrition, and light exercises.
2. Electrolyte Imbalance
- Cause : Over or under-removal of key electrolytes like potassium or calcium.
- Management : Regular blood tests and personalized dialysis plans.
3. Emotional Stress
- Cause : Lifestyle changes and dependency on treatment.
- Management : Counseling, support groups, and mindfulness practices.
4. Sexual side effects
Some people may experience loss of sexual desire, erectile dysfunction, or vaginal dryness.
Lifestyle Adjustments During Dialysis
Dietary Restrictions :
- Limit sodium, potassium, and phosphorus intake.
- Maintain a balanced protein diet (consult with a dietitian).
- Monitor fluid intake to avoid fluid overload.
Physical Activity :
- Participate in gentle to medium-intensity activities such as walking or practising yoga.
- Avoid strenuous activities immediately after dialysis sessions.
Mental Health Support :
- Seek counselling or join support groups for emotional well-being.
When you should consult a nephrologist?
- Persistent swelling in legs, ankles, or face.
- Difficulty breathing or unexplained shortness of breath.
- Constant fatigue, nausea, or loss of appetite.
- Blood in urine or changes in urination patterns.
- Severe or persistent high blood pressure.
- Unexplained itching or skin changes.
- Frequent muscle cramps or twitching.
- Confusion, difficulty concentrating, or memory issues
- Unmanageable electrolyte imbalances.
- Complications or concerns related to ongoing dialysis.
- Recommendations for kidney transplant evaluation.
- Sudden weight changes or fluid retention.
Conclusion
All in all, dialysis can be challenging to the patients, but it is a life-saving procedure. Despite all the kidney dialysis side effects, it can significantly improve the quality of life and longevity. Despite, the minimal complications associated with the treatment options, this is truly a blessing. By understanding the complications before hand, you can be prepared to what’s to come. It allows you at stay at peace. If you are suffering or experiencing the initial symptoms of kidney failure or conditions, consult RahiCare. We offer range of advanced dialysis treatment options at affordable prices.
