The Risks of Dialysis for Kidney Failure
Dialysis is a life-saving treatment for people with kidney failure, but like any medical procedure, it comes with risks. Whether you’re undergoing dialysis yourself or have a loved one receiving treatment, it’s important to understand the side effects of dialysis to enable you to make the right choices for your health.
What is Dialysis?
Dialysis is a procedure that helps filter waste products, excess fluids, and toxins from the blood when the kidneys can no longer perform these functions. There are two main types of dialysis: hemodialysis and peritoneal dialysis.
- Hemodialysis involves diverting blood into an external machine that filters it and then returns it to the body through a vascular access site (opening into one of your blood vessels).
- Peritoneal dialysis uses the lining of the abdomen (peritoneum) as a natural filter to remove waste and excess fluids.
Both types of dialysis can extend the life of someone with kidney failure, but they come with potential risks and complications.
Dialysis Side Effects (Both Hemodialysis and Peritoneal Dialysis)
Infection: One of the most significant risks of dialysis is infection. Hemodialysis requires vascular access (fistula, graft, or catheter), which can introduce bacteria into the bloodstream. With peritoneal dialysis, a catheter is inserted into the abdominal cavity, which also increases the risk of infections, such as peritonitis.
Anemia: Chronic kidney disease often leads to anemia, a condition in which the body doesn’t have enough healthy red blood cells to carry oxygen. Dialysis can exacerbate this problem, as it may cause blood loss or lower the body’s ability to produce red blood cells. Anemia can lead to fatigue, weakness, and shortness of breath.
Fatigue: Fatigue is a common side effect of dialysis. It can be due to several factors, including the body’s response to the removal of waste products and excess fluids, the physical strain of the dialysis procedure itself, and the underlying health issues associated with kidney failure.
Itchy skin: Many people receiving dialysis experience itchy or dry skin, which is thought to be caused by high phosphorous levels.
Sleep Disturbances: People receiving dialysis often have trouble sleeping or experience sleep disturbances due to sleep apnea or issues with their legs, such as discomfort or restless legs.
Psychological and Emotional Impact: While dialysis can extend life, it can also take a toll on mental health. The frequency and time commitment of dialysis sessions, along with the physical strain of the procedure, can lead to feelings of depression, anxiety, or burnout. It’s important to seek support from healthcare providers, friends, family, and support groups to cope with the psychological and emotional stresses of dialysis.
Hemodialysis Side Effects
Damage to Blood Vessels and Tissues: Long-term dialysis can damage blood vessels and tissues, especially if dialysis access sites become narrow or blocked. This may make it more difficult to access the blood for future treatments. In some cases, surgery may be required to correct these issues or create new access points.
Blood Clots and Bleeding: Hemodialysis requires the use of blood thinners to prevent clotting within the dialysis machine during the procedure. However, blood thinners increase the risk of bleeding, especially if there is a problem with vascular access. The vascular access used for dialysis can also become blocked by a clot, which must be removed, or de-clotted, to restore blood flow.
Low Blood Pressure (Hypotension): A common side effect of hemodialysis is low blood pressure, or hypotension. As fluid is removed from the body during the procedure, blood pressure can drop, which may cause symptoms such as dizziness, abdominal cramps, muscle cramps, fatigue, nausea, and vomiting. In severe cases, low blood pressure can lead to fainting or heart-related complications.
Muscle Cramps: Muscle cramps are a common side effect of hemodialysis. Adjusting fluid and sodium intake between treatments can reduce or prevent muscle cramps during treatments.
Peritoneal Dialysis Side Effects
Hernia: People receiving peritoneal dialysis are at increased risk of developing a hernia, or outpouching of the abdominal muscles, due to the stress on the muscles of the abdomen from holding fluid inside the peritoneal cavity for prolonged periods.
Weight Gain: Peritoneal dialysis can cause weight gain, because the fluid it uses contains dextrose, which is a form of sugar. The extra calories absorbed by the body can cause weight gain or high blood sugar, especially for patients with diabetes.