People on dialysis may experience various side effects, which can be related to the dialysis treatment itself or the underlying kidney failure [1]. It's often hard to determine the exact cause of these symptoms [1][2]. Dialysis side effects can be managed through lifestyle changes, medication, or adjustments to the treatment plan [5][7].
Common side effects of dialysis:
* Fatigue: Feeling tired and exhausted is a common side effect for people on long-term dialysis [1][4]. It can be difficult to determine if fatigue is a side effect of dialysis or a symptom of kidney disease [1]. Adjusting diet to increase energy levels and engaging in regular low-to-moderate aerobic exercise can help manage fatigue [4].
* Low Blood Pressure (Hypotension): This is a common side effect of hemodialysis (HD) that occurs when too much fluid is removed from the blood during treatment [3][5]. Symptoms include dizziness, nausea, lightheadedness, clammy skin, and blurry vision [5][8]. To help with low blood pressure, your healthcare team may adjust the dialysis time or frequency [8].
* Muscle Cramps: These can occur during HD due to changes in fluid or mineral balance, particularly low levels of sodium, magnesium, calcium, and potassium [3][5]. They often occur in the lower leg, but can occur anywhere in the body [7]. Doctors may prescribe medications to help with particularly painful cramps [7].
* Itchy Skin (Pruritus): This may be caused by the build-up of waste products in the blood between dialysis sessions [5]. It can also be a symptom of advanced kidney disease [1]. If itchiness is primarily in the legs, it could be due to restless leg syndrome [5].
* Infection: There is a risk of infection at the access site for both types of dialysis [5]. In hemodialysis, this can occur at the vascular access site [1]. Peritoneal dialysis (PD) can lead to peritonitis, a bacterial infection of the peritoneum [5][7]. Symptoms of peritonitis include fever, abdominal pain, nausea, vomiting, and chills [7]. Keeping the dialysis equipment clean can help to prevent peritonitis [7].
* Hernia: This is a risk for people on PD as the dialysate fluid puts extra pressure on the abdominal wall [3][5]. A hernia occurs when an organ pushes through an opening in the muscle, often presenting as a lump or swollen area [1][5].
* Weight Gain and Bloating: People on PD may experience weight gain from the sugar in the dialysis solution being absorbed by the body, as well as fluid retention [3][5]. Following the PD renal diet and doing treatments after meals can help [3].
* Blood Clots: Clots can occur in the vascular access site with HD and in the catheter with PD [3][5]. Monitoring the access site daily to check for proper function is important [3].
Other potential side effects:
* Nausea and Vomiting: These can occur due to the buildup of toxins in the blood, or other factors [8]. Doctors may be able to recommend possible treatments [8].
* Feeling Full: Some people on PD may feel full from the dialysis solution, which can make eating uncomfortable [3].
* High Blood Sugar: The dextrose in the dialysate may raise blood sugar levels, especially in people with diabetes on PD [5]. An icodextrin solution is available for those with hyperglycemia [5].
* Dry Mouth, Insomnia, Bone and Joint Pain, Anxiety, Erectile Dysfunction, and Decreased Sex Drive: These are other side effects that can occur from hemodialysis. Doctors may recommend changes to the treatment plan or lifestyle to improve these symptoms [7].
Management and coping strategies:
* Communicate with your healthcare team: Report any new or worsening symptoms to your healthcare team. They can help determine the cause and adjust your treatment plan as needed [8].
* Dietary adjustments: Work with a dietitian to adjust your diet to manage fatigue, weight gain, and other side effects [4][5].
* Regular Exercise: Low-to-moderate aerobic exercise can help with fatigue and weight management [4][5].
* Medications: Doctors may prescribe medications to help with specific side effects, such as muscle cramps [7].
* Monitor Access Site: Check your access site daily to make sure it is working properly and to help reduce the risk of infection [3][5].
* Frequent Dialysis: More frequent dialysis sessions may reduce the risk of low blood pressure and weight gain [5].
Dialysis can cause a range of side effects, but with proper management, people on dialysis can still live a full life [5].
Citations:
[1] https://www.kidney.org/kidney-topics/dialysis
[2] https://www.kidney.org/kidney-topics/hemodialysis
[3] https://www.davita.com/treatment-services/dialysis/on-dialysis/some-physical-side-effects-of-dialysis-and-how-to-prevent-them
[4] https://www.nhsinform.scot/tests-and-treatments/non-surgical-procedures/dialysis/
[5] https://www.healthline.com/health/kidney-health/dialysis-side-effects
[6] https://www.nhs.uk/conditions/dialysis/
[7] https://www.medicalnewstoday.com/articles/dialysis-side-effects
[8] https://www.kidney.org/news-stories/coping-symptoms-while-dialysis
[9] https://my.clevelandclinic.org/health/treatments/14618-dialysis
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