10 Dialysis Side Effects and How To Prevent Them

Dialysis is a lifesaving treatment when you have end stage kidney disease (ESKD). But both peritoneal dialysis (PD) and hemodialysis (HD) may have side effects.

Side effects can be mild or severe, depending on your condition and whether or not you're following your dietary and fluid guidelines. Most side effects can be managed if you follow your care team's recommendations. 

PD Side Effects

1.    Hernia

A hernia is a possible side effect of PD, a type of home dialysis treatment. The insertion of a catheter to allow dialysis solution in and out of the abdominal cavity can weaken the abdominal muscles that keep your internal organs in place. When you do an exchange (the process of filling, dwelling and draining dialysis solution), the dialysis solution puts pressure on these already weak muscles. This can cause a tear, through which the organs could push out. Surgery is the only way to repair a hernia.

2.    Feeling too full

Some people on PD find eating uncomfortable because the dialysis solution makes them feel full. Eating less may feel better, but it can lead to malnutrition. Stick to the PD renal diet, which is designed to meet your nutritional needs. Also, try to do treatments after meals to help relieve some of the discomfort.

3.    Bloating and weight gain

If you experience bloating and weight gain, you're not alone. These are common complaints from people on PD. Some of the weight is fluid bloat from the dialysis solution. Weight gain can also come from the sugar in the dialysis solution being absorbed by the body and lead to extra pounds. Ask your renal dietitian and nurse how to balance nutritional needs and feel more comfortable.   

HD Side Effects

4. Low blood pressure

The most common hemodialysis side effect is low blood pressure, which can occur when too much fluid is removed from the blood during treatment. This causes pressure to drop, causing nausea and dizziness. Tell your dialysis team if you experience any of these issues.

Note: Don't take medication for high blood pressure before treatment, unless your doctor prescribes it that way.

5. Muscle cramps

Some people get muscle cramps with hemodialysis when too much fluid is removed or removed too quickly. Your doctor may be able to recommend some remedies.

6. Blood clots

An access can become clotted with blood. Monitor your access daily by checking for the thrill (the pulse feeling in the fistula or graft) to make sure it's working properly. 

7. Itchy and/or dry skin

There can be several causes, but it's commonly thought that high phosphorous levels are responsible for itchy skin. Phosphorous isn't effectively removed by dialysis, so foods with phosphorus are restricted on the renal diet. Following your dietitian's guidelines and taking a phosphorus binder can help prevent this side effect. People on dialysis are also prone to dry skin, which can be the cause of itching. Avoid hot showers and harsh soaps, and use moisturizing creams.

PD and HD Side Effects 

8. Infection

PD: In PD, there is a risk of peritonitis, an infection at the catheter site. Peritonitis can cause fever, nausea, vomiting and stomach pain. If you have an infection, you may notice your dialysis solution looks cloudy. Treating peritonitis quickly is the key to stopping widespread infection.

To decrease the chance of infection, perform your treatment in a clean area. Your care team may also be advise you to apply an antibiotic preparation at your catheter exit site.

HD: For people on HD, the access (either a fistula or a graft) can become infected or inflamed with hemodialysis. Keeping the area clean can help prevent infection.

9. Sexual side effects

Dialysis may cause sexual side effects, which can include loss of desire, erectile dysfunction and vaginal dryness.

10. Mental illness

Having a chronic illness like kidney disease can be hard. On top of physically not feeling well, you may also feel anxiety, depression and a change in self-image. Talk to your social worker or doctor if you experience any of these symptoms. Your care team is there to help you feel your best. You can also find emotional support articles on DaVita.com, such as “Managing Feelings of Loneliness” and “4 Ways to Help Manage Mental Health and Kidney Disease.”