Common Side Effects of Dialysis and How to Manage Them

Dialysis is a life-saving procedure that helps patients with kidney failure remove waste products, toxins, and excess fluids from their blood when their kidneys can no longer perform these functions effectively. While dialysis greatly improves quality of life and extends survival, it can sometimes come with side effects. Understanding these side effects—and knowing how to manage them—can help patients lead more comfortable, healthier lives.

In this blog, Dr. Sandeep Morkhandikar, a Dialysis Specialist in Pune and one of the Best Nephrologists in Pune, explains the common side effects of dialysis and offers practical tips to manage them effectively.

1. Fatigue and Weakness

The Problem:
Feeling tired after dialysis is one of the most commonly reported issues. Fatigue occurs because dialysis removes fluid and waste rapidly, which can affect blood pressure and cause a temporary drop in energy levels.

How to Manage:

• Stay hydrated as advised: Drink fluids according to your nephrologist’s recommendations. Overhydration or dehydration can worsen fatigue.
• Eat a balanced diet: Include iron, protein, and vitamins as prescribed by your dietician to combat anemia and weakness.
• Get enough rest: Ensure you have adequate sleep and avoid strenuous activities immediately after dialysis sessions.
• Stay active: Light exercises like walking or stretching can boost energy levels over time.

2. Low Blood Pressure (Hypotension)

The Problem:
During hemodialysis, your blood is filtered through a machine, which can sometimes lead to a drop in blood pressure. Symptoms may include dizziness, nausea, sweating, or fainting.

How to Manage:

• Avoid heavy meals before dialysis: A full stomach can worsen low blood pressure during treatment.
• Follow fluid restrictions: Excess fluid between sessions increases the risk of low BP during dialysis.
• Notify your care team: Inform the dialysis nurse if you feel dizzy or lightheaded—they may adjust your treatment settings.
• Use prescribed medications carefully: Blood pressure medications may need to be timed differently on dialysis days, as directed by your nephrologist.

3. Muscle Cramps

The Problem:
Muscle cramps, especially in the legs or feet, are frequent during or after dialysis. These occur due to rapid fluid removal or electrolyte imbalances.

How to Manage:

• Stretch before and after dialysis: Gentle stretching can reduce muscle tension.
• Adjust your fluid removal rate: Speak with your dialysis specialist if cramps persist—they may alter your treatment parameters.
• Stay within your fluid limit: Excess fluid gain between sessions increases cramping risk.
• Balance electrolytes: Ensure your sodium and potassium intake matches medical recommendations.

4. Itchy Skin (Pruritus)

The Problem:
Chronic itching is a frustrating issue for many dialysis patients. It may result from a buildup of phosphorus in the blood, dry skin, or allergic reactions to dialysis materials.

How to Manage:

• Control phosphorus intake: Avoid high-phosphorus foods like dairy, nuts, and processed meats, and take phosphate binders as prescribed.
• Moisturize regularly: Use fragrance-free lotions to prevent dryness.
• Take lukewarm showers: Hot water can worsen itching.
• Report persistent itching: Your doctor may prescribe antihistamines or adjust your dialysis routine.

5. Nausea and Vomiting

The Problem:
Some patients experience nausea or vomiting, especially during the initial stages of dialysis or when fluid is removed too quickly.

How to Manage:

• Eat light before treatment: Avoid heavy or greasy meals before dialysis sessions.
• Control fluid removal: Gradual removal may help reduce nausea.
• Take prescribed medications: Antiemetic medications can help manage nausea if approved by your nephrologist.
• Monitor blood urea levels: High levels can contribute to nausea and may need adjustment through dietary or treatment changes.

6. Headaches

The Problem:
Dialysis headaches can occur due to fluid shifts, blood pressure changes, or electrolyte fluctuations during treatment.

How to Manage:

• Monitor caffeine intake: Sudden withdrawal can trigger headaches.
• Ensure adequate rest: Fatigue and lack of sleep can worsen symptoms.
• Control blood pressure: Work with your nephrologist to maintain optimal BP levels.
• Ask for gradual dialysis settings: Slower fluid removal may help reduce headache frequency.

7. Restless Leg Syndrome (RLS)

The Problem:
RLS is a condition where patients feel an uncontrollable urge to move their legs, especially during rest or dialysis sessions. It can interfere with sleep and comfort.

How to Manage:

• Check iron levels: Iron deficiency is often linked to RLS.
• Engage in light exercise: Gentle leg stretches or walking may reduce symptoms.
• Avoid caffeine and nicotine: These can aggravate RLS.
• Consult your nephrologist: Medications can help manage severe cases.

8. Infection or Access Site Complications

The Problem:
The dialysis access site (fistula, graft, or catheter) can sometimes become infected or develop clotting issues.

How to Manage:

• Maintain hygiene: Wash hands and clean the access site before and after dialysis.
• Monitor for signs of infection: Redness, swelling, or pain around the access site should be reported immediately.
• Avoid tight clothing or pressure: Protect your access arm from injury.
• Follow your care team’s guidance: Regular monitoring ensures early detection and treatment of any issues.

Living Well with Dialysis

Dialysis can be challenging, but with the right care and support, most patients can live full and active lives. Regular follow-ups with your nephrologist, adhering to dietary guidelines, and monitoring your symptoms can make a significant difference.

If you experience persistent side effects or sudden changes in your health, consult a kidney care expert immediately.

About Dr. Sandeep Morkhandikar

Dr. Sandeep Morkhandikar is a highly experienced Dialysis specialist in Pune and one of the Best nephrologists in Pune, known for his patient-centered approach to kidney care. He specializes in managing chronic kidney disease (CKD), dialysis, and renal transplant cases with compassion and expertise, helping patients lead healthier, more comfortable lives.

In summary:
While dialysis can cause certain side effects, they can be effectively managed through proper medical guidance, diet, and self-care. With the right support from a qualified nephrologist, patients can experience improved quality of life and better kidney health outcomes.