Dialysis - Risks
Alternative Names
Artificial kidneys; Hemodialysis; Peritoneal dialysis; Renal replacement therapy
What the risks are:
The immediate risks include:
- A small bubble of air in the blood that travels to a blood vessel in another part of the body (air embolism)
- Bleeding from the access site
- Cramps
- Dialyzer reaction
- Electrolyte imbalance
- Infection
- Irregular heartbeat or ischemia
- Low blood pressure (hypotension)
- Nausea and vomiting
Long-term risks include:
- Autonomic neuropathy
- Blood loss leading to iron deficiency
- Cardiovascular disease
- Dialysis-associated amyloidosis
- Dialysis dementia
Special considerations:
Take the following precautions if you are using an AVF or AVG:
- Do not allow anyone to take a blood pressure reading on an arm with the access.
- Do not use creams or lotions over the access site.
- Do not wear tight clothing around the access site.
- Observe the access site after dialysis, watching for swelling, infection, or bleeding.
- Routinely check the access site for the "thrill," indicating that the AV site is still functioning. (If the thrill disappears, call your health care provider immediately.)
- When you sleep, avoid placing pressure on an arm with the access (if the graft or fistula clots, you may need a new one).
If you have an external access, take these additional precautions:
- Avoid physical activity that might dislodge the access, which could result in excessive bleeding and air entering the circulatory system. (If this happens, call 911 and get immediate medical attention.)
- Call your health care provider immediately if you have a fever or other sign of infection.
- If the color in the tubes changes and becomes a dark red, call your health care provider immediately. (The blood may be clotting.)
If you perform peritoneal dialysis at home:
- Report any fever immediately.
- Report any pain in your abdomen immediately.
- Report any cloudiness or change in fluid color.
Do not miss or skip any dialysis sessions.
- Reviewed last on: 10/15/2008
- Parul Patel, MD, Private practice specializing in Nephrology, Kidney and Pancreas Transplantation, affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
References
Tolkoff-Rubin N. Treatment of irreversible renal failure. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 133.
Mitch WE. Chronic kidney disease. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 131.