Hemodialysis uses an artificial kidney to remove waste products and water from your blood as your kidney does. It is used to treat advanced kidney failure or end-stage kidney disease. Hemodialysis maintains your blood pressure and mineral concentrations like potassium, sodium, and calcium in your blood and keeps your body healthy and active. Despite the benefits, it is important to be aware of the complications of hemodialysis.
Here are some common complications:
Hypotension
Hypotension or low blood pressure during hemodialysis is known as intradialytic hypotension. It usually occurs during the onset of hemodialysis with systolic pressure less than 90mmHg. It has multiple reasons, but the most frequent are:
- Removing too much weight from the body
- Taking anti-hypertensive drugs before dialysis
- Heart diseases like arrhythmia
A sudden reduction in blood pressure results in an increased pulse rate, cold skin, muscle aching, nausea, vomiting, chest pain, pale skin, seizures, and unconsciousness. Maintaining fluid intake and refraining from eating throughout the procedure will help you avoid the fatal risks of hypotension.
Additionally, ensure your care team has an up-to-date list of all the drugs you use at home.
Muscle Cramps
Muscle cramping is the most common and challenging complication of hemodialysis. During hemodialysis, muscular cramps occur almost 35-86% of the time. The most common causes of muscle cramping during hemodialysis are:
- The removal of excessive amounts of fluid
- A change in electrolyte balance
- Low blood pressure.
Moreover, muscle cramps can happen at any time during dialysis, but mainly in the middle and end of the procedure. It usually affects your limbs or extremities. If you feel such pain or discomfort, mention it to your caretakers so that they take immediate action to prevent further complications.
Infection
The process of hemodialysis needs an artificial entry point to your body. This artificial point of entry is a potential source of infection. You may get an infection because:
- Bacteria and other microbes now have an easier access to your blood.
- If you are taking iron supplements, it may increase the chance of infection by damaging your neutrophils and T-cells.
You may have an infection if you experience fever, chills, redness, swelling, or a deposit of pus under your skin. Don’t panic; utilizing antibiotics and excellent hygiene or sanitary practices will help you control infection.
Above all, the dialysis access should never be bumped or knocked because this could result in bleeding, which in turn increases the risk of infection.
Fluid Overload
Fluid overload or hypervolemia occurs when your kidney can’t remove extra fluid from your body due to chronic kidney disease. It may also happen if your dialysis machine is not correctly calibrated during dialysis.
If you are suffering from headaches, abdominal bloating, shortness of breath, and sleep apnea, or you are gaining weight, then you may have hypervolemia. A fluid overload could be fatal because it increases the chance of high blood pressure and heart disease.
Therefore, it is crucial to prevent it by:
- Reducing sodium intake
- Following your dialysis plans properly
- Measuring your fluid intake
- Controlling diabetes and body weight
Disequilibrium Syndrome
Disequilibrium syndrome (DDS) is a collection of neurological symptoms that primarily appears at the beginning of dialysis. It is due to your body’s reaction to the abnormal procedure, resulting in the release of inflammatory chemicals that leads to the swelling of your brain. Moreover, it may also occur due to sudden changes in your serum electrolyte balance.
You may suffer from disequilibrium syndrome if you have the following symptoms:
- Fatigue, Nausea, and vomiting
- Headache
- High blood pressure
- Difficulty in speech
- Fits
Although DDS is a short-lived complication, you can prevent it by routinely monitoring your blood pressure and serum electrolytes. Moreover, your doctor may use intravenous saline injections to reduce brain swelling.
Pyrogen Reaction
Pyrogen reaction is the most common complication of dialysis due to the reuse of a dialyzer and the intense flow of dialysis. It is a fever reaction brought on by dead microorganisms (endotoxins) in your body. Furthermore, it may happen due to the contamination of the dialyzer and bicarbonate & water complex.
Cold body sensations, chills, headaches, and low blood pressure are the most common symptoms of pyrogen reaction. If you have such symptoms, report them immediately to your doctor to seize the treatment. Further, you can reduce the risk of pyrogen reaction by proper sanitization of the dialyzer machine using aseptic methods.
Anemia
Anemia is a decreased number of red blood cells in your blood. Hemodialysis patients frequently have anemia, which causes symptoms including fatigue, sadness, less exercise tolerance, and shortness of breath, leading to impaired kidney function.
In chronic kidney disease, your kidneys are unable to produce enough erythropoietin hormone, which aids in the stimulation of red blood cell synthesis. Additionally, anemia may occur due to poor diet, reduced iron absorption, and removal of an excessive amount of vitamins and iron from your body during hemodialysis. Frequent blood draws and bleeding also contribute to anemia.
The best strategy to avoid anemia while receiving hemodialysis is to maintain a healthy diet and routine blood checks.
Itching
During hemodialysis, your kidney can’t remove enough phosphorus from your body, which results in itchy and dry skin, and it typically gets worse either during or after dialysis. Besides phosphorus, below are some reasons for itching:
- Abnormal amount of calcium and magnesium in body tissues
- Skin allergies
- Using skin care products containing alcohol
You can prevent dry and itchy skin with enough dialysis to control electrolyte levels and avoid skin care products having retinoids and alcohol. Moreover, follow your dialysis plan and reconduct any missed treatment to maintain adequate dialysis for maintaining electrolyte balance in your body.
Headache
Headache is the most common complication of hemodialysis patients. Almost 27 to 73% of people experience headaches during dialysis. It persists for a few hours after the initiation of dialysis. The most frequent causes of headaches during hemodialysis are:
- High blood pressure
- An excessive amount of fluid removal from the body
- Disequilibrium Syndrome
- Anxiety or depression
Headaches may lead to deadly diseases, so you should prevent them by proper screening during or after dialysis. Furthermore, finding the source of your headaches can also help you get the best care.
Chest Pain
If you have end-stage kidney failure, you may experience chest pain during or after hemodialysis. Angina and myocardial infarction (MI)are possible causes of chest pain. If you have decreased oxygen supply to your heart muscles, then you may have angina. However, chest pain because of the death of heart tissues may be due to a heart attack or MI.
Therefore, if you feel any pain or discomfort in your chest, jaw, shoulder, neck, back, or arm, report it immediately to your doctor to get the possible treatment. However, you can prevent this by precise fluid removal and regular assessment of your body weight.
Wrap Up
Hemodialysis stimulates kidney function in patients with chronic or end-stage kidney disease. If hemodialysis is performed too quickly and doesn’t remove all waste products from your body or if you don’t follow the recommended diet plan, it may result in complications.
Hemodialysis risks include itchiness, chest pain, muscle cramps, fluid overload, infection, disequilibrium syndrome, and headache. You can help prevent the side effects of hemodialysis by proper monitoring and assessment during or after the dialysis and following the treatment plan.
Above all, let your doctor know about any issues as soon as possible.
