Dialysis

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Kidney anatomy

Kidney - blood and urine flow

Artificial kidneys; Hemodialysis; Peritoneal dialysis; Renal replacement therapy;

The immediate risks include:

• Hypotension (low blood pressure)
• Infection
• Electrolyte imbalance
• Bleeding from the access site
• Nausea and vomiting
• Cramps
• Dialyzer reaction
• Air embolism
• Cardiac ischemia or arrhythmia (irregular heart beats)

Long-term risks include:

• Dialysis-associated amyloidosis
• Dialysis dementia (uncommon now that aluminium levels are closely monitored)
• Cardiovascular disease
• Autonomic Neuropathy
• Blood loss leading to iron deficiency (requiring regular iron replacement)

Take the following precautions if you using an AVF or AVG:

• When you sleep, avoid placing pressure on an arm with the access.
• Do not allow anyone to take a blood pressure reading on an arm with the access.
• Observe the access site after dialysis, watching for swelling, infection, or bleeding.
• Do not wear tight clothing around the access site.
• 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.)
• Do not use creams or lotions over the access site.

• 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.)
• If the color in the tubes changes color and becomes a dark red, call your health care provider immediately. (The blood may be clotting.)
• Call your health care provider immediately if your have a fever or other sign of infection.

Review Date: 12/09/2005
Reviewed By: Colm C. Magee, MD, MPH, Medical Director, Renal Transplant, Brigham & Women's Hospital, and Assistant Professor, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.