Overview
Dialysis helps do some of the work of healthy kidneys when the kidneys can no longer filter waste and extra fluid well enough. Dialysis-related conditions are medical problems linked to the treatment itself or to advanced kidney disease in people receiving hemodialysis or peritoneal dialysis. Some happen suddenly during treatment, while others build up over time.
Key Symptoms
Symptoms vary by the type of complication. People may have dizziness, faintness, muscle cramps, nausea, headache, weakness, swelling, shortness of breath, chest discomfort, itching, fever, redness around an access site, or cloudy drainage in peritoneal dialysis. Some people also notice trouble sleeping, numbness or tingling, poor appetite, or ongoing tiredness.
Causes and Risk Factors
Problems can develop from rapid fluid removal, changes in blood pressure, infection, clotting of the dialysis access, or irritation of the lining of the abdomen in peritoneal dialysis. Risk may be higher in older adults and in people with diabetes, heart disease, poor nutrition, weakened immune systems, or a central venous catheter. Missing treatments, not following fluid limits, or difficulties with dialysis equipment or access care can also increase risk.
Who Is Affected
Dialysis-related conditions affect people with kidney failure who receive hemodialysis or peritoneal dialysis. The type of complication often depends on the kind of dialysis, the access used, other medical conditions, and how long a person has been on treatment. Children and adults can both be affected.
Prevention
Prevention focuses on careful dialysis planning, regular follow-up, and good access care. Hand hygiene, correct cleaning of catheters or fistula sites, attending scheduled treatments, and reporting new symptoms early can lower the chance of serious complications. Following advice about fluids, salt, and other parts of the treatment plan may also help reduce problems.
Diagnosis and Tests
Healthcare teams diagnose dialysis-related problems by asking about symptoms, examining the access site, and reviewing dialysis sessions. Blood tests may check electrolytes, anemia, infection, bone-mineral balance, and how well dialysis is working. Imaging or access flow studies may be used if there is concern about blockage, clotting, or infection.
Treatment Categories
Treatment depends on the complication and may include changes to the dialysis prescription, closer fluid management, access repair, infection treatment, or care for symptoms such as itching or cramps. Long-term complications may need coordinated care for bone health, heart health, anemia, nerve symptoms, or mental well-being. People should follow the plan given by their dialysis team and ask how to respond if symptoms happen at home.
Living With It
Living with dialysis-related conditions can be physically and emotionally demanding. Keeping a symptom diary, bringing questions to dialysis visits, and knowing the warning signs of access problems can help people take part in their care. Support from family, community, patient groups, and mental health professionals may also be helpful.
Diet and Lifestyle
Diet needs often change on dialysis and may involve limits on fluids, sodium, potassium, or phosphorus depending on the person's condition and type of treatment. Avoiding tobacco, staying as active as your healthcare team allows, and keeping all medical appointments support overall health. People should only make major diet changes with guidance from their kidney care team.
When to Seek Medical Care
Contact a healthcare professional promptly for fever, chills, redness, drainage, new swelling, worsening itching, repeated vomiting, severe fatigue, dizziness after dialysis, or trouble with the fistula, graft, or catheter. Also seek care for missed dialysis sessions, sudden weight gain, reduced fluid removal, or cloudy peritoneal dialysis fluid. Early evaluation can help prevent more serious complications.
When It May Be an Emergency
Get urgent medical help right away for severe shortness of breath, chest pain, fainting, confusion, heavy bleeding from an access site, signs of stroke, seizures, or a high fever with rigors. Emergency care is also needed if a dialysis catheter is pulled out, if there is severe abdominal pain during peritoneal dialysis, or if an access site suddenly stops working and the person becomes very unwell. If symptoms feel severe or rapidly worsening, do not wait for the next dialysis session.
Questions to Ask a Healthcare Professional
Helpful questions include: What complications should I watch for with my type of dialysis? How should I care for my access site at home? What symptoms mean I should call the dialysis unit, and which mean I should seek emergency care right away? You can also ask how diet, fluids, travel, and missed treatments affect your risk.