Side effects - Dialysis

Both haemodialysis and peritoneal dialysis cause side effects. This is because of the way dialysis is carried out and the fact it can only partially compensate for the loss of kidney function.

Fatigue

Fatigue, where you feel tired and exhausted all the time, is a common side effect in people who use either form of dialysis on a long-term basis.

Fatigue is thought to be caused by a combination of the:

• loss of normal kidney function
• effects dialysis can have on the body
• dietary restrictions associated with dialysis
• overall stress and anxiety that many people with kidney failure experience

You may want to talk to your dietitian to see if your diet can be adjusted to increase your energy levels.

Regular exercise may also help. If you're fatigued and on dialysis, starting a programme of regular exercise can be difficult. 

But if you persevere, you'll probably find that exercising becomes easier with time.

Low-to-moderate aerobic exercise, such as cycling, running, walking or swimming, is best.

A GP or dialysis care team will be able to advise you about the type of exercise most suitable for you.

Side effects of haemodialysis

Low blood pressure

Low blood pressure (hypotension) is one of the most common side effects of haemodialysis.

It can be caused by the drop in fluid levels during dialysis. Low blood pressure can cause nausea and dizziness.

The best way to minimise these symptoms of low blood pressure is to keep to your daily fluid intake recommendations.

If your symptoms persist, you should consult your dialysis care team as the amount of fluid used during dialysis may need to be adjusted.

Sepsis

People receiving haemodialysis are at increased risk of developing sepsis (blood poisoning).

This is where bacteria enter the body and spread through the blood, potentially leading to multiple organ failure.

Warning symptoms include dizziness and a high temperature.

If you have a high temperature, phone your dialysis unit immediately for advice. Alternatively, you can contact NHS 111 or your local out-of-hours service.

If you develop sepsis, you'll need to be admitted to hospital and treated with injections of antibiotics.

Muscle cramps

During haemodialysis, some people experience muscle cramps, usually in the lower leg.

This is thought to be caused by the muscles reacting to the fluid loss that happens during haemodialysis.

Consult your dialysis care team if you have muscle cramps that become particularly painful. Medicine may be available to help you cope with the symptoms.

Itchy skin

Many people receiving haemodialysis experience itchy skin, caused by a build-up of minerals in the body between dialysis sessions.

Tell your care team if your skin becomes itchy. They may recommend creams to soothe and moisturise your skin.

Other side effects

Other side effects of haemodialysis can include:

• difficulties falling asleep (insomnia) or staying asleep
• bone and joint pain
• loss of libido (sex drive) and erectile dysfunction
• dry mouth
• anxiety

There is evidence to suggest that having more regular haemodialysis at home could help to ease some of these side effects.

Side effects of peritoneal dialysis

Peritonitis

A common side effect of peritoneal dialysis is bacterial infection of the peritoneum (peritonitis).

Peritonitis can happen if the dialysis equipment is not kept clean. If there are bacteria on the equipment, they can spread to the peritoneum, the thin layer of tissue that lines the inside of the abdomen.

The most effective way to prevent peritonitis is to keep your dialysis equipment clean. You'll be given training in how to do this.

Signs and symptoms of peritonitis can include:

• abdominal pain
• a high temperature
• feeling and being sick
• experiencing chills
• the used dialysis fluid becoming cloudy

Contact your dialysis unit immediately if you develop these symptoms. Alternatively, you can contact NHS 111 or your local out-of-hours service.

Peritonitis is treated with injections of antibiotics. If the infection is severe or keeps coming back, you may need to switch to haemodialysis.

Hernia

People receiving peritoneal dialysis are at increased risk of developing a hernia.

This is because holding fluid inside the peritoneal cavity for many hours puts a strain on the muscles of the abdomen.

The main symptom of a hernia is the appearance of a lump in your abdomen. The lump may be painless and may only be discovered during a check-up.

In some people, certain activities, such as bending over or coughing, can cause the lump to appear.

Surgery is usually needed to repair a hernia. During surgery, the surgeon will place the protruding tissue back inside your abdominal wall.

The muscles of the abdominal wall may also be strengthened using a synthetic mesh.

Weight gain

The dialysate fluid used during peritoneal dialysis contains sugar molecules, some of which are absorbed into your body.

This can increase your daily calorie consumption by up to several hundred calories a day.

If you do not compensate for these extra calories by reducing the amount of calories you eat and taking regular exercise, it's likely you'll gain weight.

If you're concerned that you're gaining too much weight, you should talk to your dialysis team, who can recommend a diet and exercise plan.

Avoid following fad diets that claim to be able to help you lose a lot of weight quickly. This type of extreme dieting could upset your body's chemistry and make you feel very ill.