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Side effects of treatment

dialysis side effects?

Coping with unpleasant things that may come with dialysis

Regular, effective dialysis treatments mean a longer and healthier life. It means more energy and time to do what you love.

Living on dialysis can also mean having to cope with one or more side effects of treatment. There’s no doubt about it, whether big or small, side effects are annoying and sometimes maddening.

The good news is that there are many things you can do to reduce your risk of side effects and also treatments for them if you need it. Your care team is ready to answer your questions and help you manage any side effects that may come your way. 
dialysis webinar

Ways to cope with dialysis side effects

Gopa, a kidney doctor, and Diane, a dialysis social worker, chat about ways to manage common side effects such as dry, itchy skin; post-dialysis fatigue and recovery; and sleep problems.

medical social worker

If you feel sad and hopeless

All of us have days when we feel overwhelmed, worried, or sad. If you feel this way often, talk to your social worker or someone on your care team. You’re not alone. Your care team can help you get help when life on dialysis gets hard. 

You might feel dizzy, light-headed, or very tired. These are often symptoms of low blood pressure caused when too much fluid is removed at one time during dialysis.

The best way to prevent low blood pressure is to control your fluids. Talk to your dialysis dietitian for tips on reducing sodium in your foods and managing your fluid intake.

Effective dialysis removes the right amount of toxins from the blood at each treatment. If too many toxins remain after dialysis, they build up in the blood. This is called uremia and is a serious condition that can cause nausea and vomiting.

If you experience this, tell your dialysis nurse or doctor when you feel nauseated or like you need to vomit. This could mean that an adjustment to your treatment and/or meal plan may be needed.

Red blood cells carry oxygen to all parts of your body to give you energy. Many people with kidney disease don’t make enough red blood cells. This condition is called anemia. At least once a month, your care team will test your red blood cell count to see if you have anemia.

If you are experiencing any of the symptoms above, you can: 

  • If you have anemia due to kidney disease, your doctor will prescribe a medication called an erythropoiesis- stimulating agent (ESA). The most common ESAs are Epogen and Aranesp. These medications help your body make red blood cells so you can have more energy and avoid blood transfusions and their risks.
  • Your kidney doctor may increase the amount of iron you get. While this might include eating more iron-rich food and/or taking iron pills, iron injections may be needed because people on dialysis often don’t absorb iron well through food or supplements.

There are many reasons why skin may be dry or itchy. It may be hot/cold weather or a skin allergy. Dry, itchy skin can also be a result of too much or too little dialysis or too much phosphorous in your blood.

If you start to experience dry and/or itchy skin, talk to your care team about your skin. Ask your dialysis dietitian to check your phosphorous levels from your monthly lab work.

Also, avoid fragrances in anything you put on your skin and shop for a soap that doesn’t dry out your skin.

Restless leg syndrome is characterized by uncomfortable feeling of crawling, prickling, or itching. You may feel the need to keep your legs moving, especially while sitting or lying down, making it hard to sleep.

RLS can have multiple causes, such as some forms of kidney disease, uremia (not enough dialysis), iron deficiency, or neuropathy (nerve damage).

If you are experiencing this, speak to your healthcare team for a diagnosis and a prescription which will help address the specific cause.  There are many medications that may help this condition. 

Some symptoms include feeling tightness or pain in your muscles, especially those in your arms and legs. The exact cause is unknown, but doctors think it may have something to do with fluid removal and electrolyte shifts. 

To help with muscle cramping you can:

  • Avoid large fluid gains between dialysis treatments.
  • Gently stretch the cramped muscle.
  • Place something warm on the muscle to increase circulation.
  • If the cramping is severe, ask your care team if there’s a medication that might help.
  • Tell your care team when you have cramping so they can look into a possible cause and help you find the right treatment.
  • During dialysis, they may have to temporarily slow the fluid removal that’s being performed.

Some symptoms you might experience are bone pain or weak bones that break easily. The reason is when your kidneys don’t work properly, too much phosphorus can build up in your blood. This can lead to an imbalance in the hormone that releases calcium from your bones, and overtime weakens the bones and may harm the heart.

To prevent this from happening: 

  • Control phosphorus in your diet and take any prescribed phosphorus binders with every meal.
  • Take other doctor-prescribed medications such as Vitamin D, Calcimimetics, or Calcium supplement. Talk to your kidney doctor before taking any over the counter supplements or medications, particularly certain things such as Fleets enemas that contain high levels of phosphorous.
  • Ask your doctor about light exercise that may prevent broken bones.
  • Come to every dialysis treatment and stay for your full treatment time.