Are you aware of dialysis side effects and how they can impact your daily life? While dialysis is essential for patients with kidney failure, it can lead to a variety of physical and emotional challenges. Some of the most common dialysis side effects include low blood pressure, weight fluctuations, blood clots, and persistent fatigue. Although many of these symptoms can be managed through proper hydration, dietary changes, and personalized treatment plans, others may signal more serious concerns that require immediate medical attention. Understanding the full scope of dialysis side effects empowers patients and caregivers to act early, reduce discomfort, and prevent complications.
If you or a loved one is currently undergoing dialysis—or preparing to start—it’s important to receive care from a compassionate, well-equipped team. At Doral Health and Wellness, we provide professional hemodialysis services in Brooklyn, along with patient education to help you better manage treatment outcomes. You can visit our clinic or learn more about our services at https://doralhw.org/solution/dialysis/.
Common Dialysis Side Effects
Here are the common side effects you may experience with dialysis treatment.
If you’re getting hemodialysis (HD) done, then you may experience side effects such as:
Low Blood Pressure
One of the most common dialysis side effects is low blood pressure, especially during or immediately after a session. This occurs when the dialysis process removes too much fluid from your bloodstream too quickly, causing a sudden drop in blood pressure. As a result, you may feel dizzy, lightheaded, nauseated, or even faint. Some people also report clammy skin, muscle cramps, and blurred vision—signs that should not be ignored.
These symptoms can interfere with your ability to resume normal activities after treatment, and in more serious cases, may increase your risk of falls or other injuries. That’s why it’s crucial to communicate any discomfort to your dialysis care team right away, so they can adjust your fluid removal settings or explore other supportive options.
It’s also important to manage your medications carefully. Avoid taking high blood pressure drugs before treatment unless your nephrologist specifically advises it. Your care team can help you develop a medication schedule that minimizes the risk of low blood pressure while still controlling your overall health condition.
Being informed about dialysis side effects like hypotension is key to staying safe and comfortable during your treatment journey.
Muscle Cramps
Among the many dialysis side effects that patients experience, muscle cramps are one of the most uncomfortable and disruptive. These cramps often occur during or shortly after a dialysis session and are typically caused by a rapid or excessive removal of fluids. When this happens, it can disturb the balance of important electrolytes in your body—such as sodium, calcium, magnesium, and potassium—which are essential for normal muscle function.
As a result, you may feel sudden, sharp pain in your legs, feet, or hands that can interfere with your ability to move or relax comfortably. These muscle cramps may vary in intensity and duration, and if left unaddressed, they can reduce your tolerance for treatment sessions and affect your overall quality of life.
Fortunately, this is one of the dialysis side effects that can often be managed effectively. Your doctor or care team may recommend slowing the fluid removal rate, modifying your diet to ensure adequate electrolyte intake, or trying gentle stretching exercises before and after treatment. In some cases, certain medications or natural remedies may also be suggested to provide relief and reduce recurrence.
Communicating openly with your dialysis team about muscle cramping is essential to finding the right strategy for prevention and comfort.
Itchy Skin
Itchy skin is one of the most frustrating dialysis side effects that many patients deal with between treatment sessions. This condition, medically referred to as pruritus, can range from mild to severe and often interferes with sleep, focus, and daily comfort. Among the most common causes is the accumulation of waste products in the blood, which gradually builds up between dialysis treatments. Since dialysis does not fully replicate all kidney functions, certain substances—especially phosphorus—may remain in the body, triggering itching.
This makes itchy skin one of the more persistent dialysis side effects, especially in individuals with elevated phosphorus levels. Because phosphorus is not easily removed through dialysis alone, patients are often advised to follow a phosphorus-restricted diet. This means avoiding foods like dairy, nuts, beans, and certain meats. Managing phosphorus levels through diet and phosphate binders is key to minimizing this specific dialysis side effect.
In other cases, itchy skin may be localized to the legs or feet and could be related to conditions like restless legs syndrome. Additionally, dry skin after dialysis can intensify the discomfort, making this one of the dialysis side effects that may require both medical and lifestyle strategies. To reduce dryness, patients are advised to avoid hot showers, harsh soaps, and instead opt for gentle cleansers and regular moisturizing with hypoallergenic creams.
Because dialysis side effects like pruritus can significantly affect your quality of life, it’s important to communicate symptoms early. Your care team can help determine whether the itchiness is due to mineral imbalances, skin dryness, or other related causes, and tailor a management plan that works for you.
Blood Clots
Blood clots are a serious and potentially dangerous complication and one of the more concerning dialysis side effects that patients should be aware of. During hemodialysis, an access port—either a fistula or graft—is created to allow blood to flow out of and back into the body. However, this access point can sometimes become clogged or clotted due to the narrowing or damage of blood vessels. This clotting can restrict blood flow and impair the effectiveness of dialysis treatment.
If left untreated, blood clots at the dialysis access site may lead to swelling, typically in the upper half of the body, including the arm, neck, or face. Additionally, clots can increase the risk of other serious complications, including the formation of blood clots elsewhere in the body, which can be life-threatening.
Because blood clots are a notable dialysis side effect that requires prompt attention, your dialysis care team carefully monitors the access site on a daily basis. One common technique they use is called the “Thrill” method, which involves feeling for a vibration or pulse in the fistula or graft to ensure that blood is flowing properly. If the thrill is absent or diminished, it may indicate a developing clot or blockage.
Early detection and intervention are critical in managing this dialysis side effect. Treatments may include medications to dissolve clots or procedures to open narrowed vessels, helping to restore access function and maintain effective dialysis sessions. If you notice any swelling, pain, or unusual changes around your access site, it is important to inform your healthcare providers immediately to avoid worsening complications.
Understanding blood clots as one of the common dialysis side effects empowers you to be proactive about your care and ensures you receive timely treatment to prevent serious health issues related to dialysis access.
Infections
Infections are one of the significant dialysis side effects that patients undergoing hemodialysis need to be vigilant about. Due to the frequent insertion of needles and catheters during each dialysis session, there is an increased risk of exposure to bacteria and other pathogens. These dialysis access points, if not properly cared for, can become entryways for bacteria into the bloodstream, leading to serious infections.
Bloodstream infections, also known as bacteremia, are among the most dangerous dialysis side effects because they can quickly escalate to sepsis—a life-threatening condition that requires immediate medical intervention. Sepsis occurs when the body’s response to infection causes widespread inflammation, which can damage organs and tissues.
Preventing infections as a dialysis side effect involves meticulous care of the access site. Patients and healthcare providers must ensure that the insertion area is kept clean and sterile at all times. This includes proper hand hygiene, using antiseptic solutions, and following strict protocols when handling catheters or needles.
Regular monitoring for signs of infection, such as redness, swelling, warmth, pain, or discharge around the access site, is crucial. Fever or chills may also indicate an infection related to dialysis treatment. Promptly reporting these symptoms to your dialysis care team can help prevent the progression of infection and reduce the risk of serious complications.
Infections represent a common and potentially dangerous dialysis side effect, but with proper hygiene, vigilance, and medical care, patients can significantly reduce their risk. Understanding the importance of infection control empowers dialysis patients to actively participate in their care and maintain their health during treatment.
Other Dialysis Side Effects
In addition to the more commonly discussed issues, there are several other dialysis side effects that patients may experience during their treatment journey. These dialysis side effects can affect various aspects of your health and well-being, making it essential to be aware of them and communicate any symptoms with your healthcare team promptly.
One of the significant dialysis side effects is anemia, which occurs when the body does not have enough healthy red blood cells. This condition is often linked to the kidneys’ decreased ability to produce erythropoietin, a hormone essential for red blood cell production. Anemia can cause fatigue, weakness, and shortness of breath, further complicating the dialysis experience.
Difficulty sleeping is another dialysis side effect that many patients report. Restless leg syndrome, muscle cramps, and imbalances in fluid and minerals during dialysis can disrupt your sleep patterns, leading to poor quality sleep and daytime tiredness. Managing these dialysis side effects often involves adjustments in treatment, medications, and lifestyle changes to improve overall rest.
Heart conditions are also a concern among dialysis patients. Dialysis side effects related to the cardiovascular system include arrhythmias, heart failure, and in severe cases, cardiac arrest. These complications often result from fluctuations in fluid volume, blood pressure, and mineral imbalances during dialysis sessions. Proper monitoring and managing these dialysis side effects are crucial to reducing risks and protecting heart health.
Understanding that dialysis side effects extend beyond the immediate treatment can help patients prepare for potential challenges and seek timely medical advice. Your dialysis care team will work closely with you to monitor and manage these side effects, ensuring that your treatment plan addresses both the benefits and potential risks.
If you’re undergoing peritoneal dialysis (PD), you may experience slightly different side effects, including:
- Peritonitis:
During PD, there’s a risk of peritonitis, an infection when bacteria enter the peritoneum during catheter insertion or usage and cause fever, abdominal pain, tenderness, bloating, nausea, vomiting, and stomach pain.
If you have an infection, you may see the dialysis solution getting cloudy. Treating the infection quickly is the key to stopping it from spreading to other organs. To decrease the chance of infection, perform your treatment in a clean area. Your care team may apply antibiotic preparation at your catheter exit site.
- Hernia:
A hernia can occur when an organ or fatty tissue pushes through an opening in the muscle. People who receive PD are at more risk of developing an abdominal hernia because 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. During the exchange process, it puts pressure on the already weak muscles which causes a tear and pushes the organs out. Hernia is only repaired by surgery.
- High blood sugar:
Dialysate contains a sugar called dextrose, which is used during intravenous nutrition. This sugar can raise blood sugar levels, which may put people with diabetes undergoing PD at risk of hyperglycemia.
- High potassium:
This is a common side effect of kidney failure. It occurs when potassium levels suddenly rise between dialysis sessions due to a lack of proper filtration.
- Weight gain or bloating:
Weight gain or bloating happens when additional calories are administered during dialysis (use of dialysate) or fluid bloat from dialysis solution. However, other factors also affect weight gain during dialysis such as lack of exercise and nutrition. If that happens you can ask your renal dietitian and nurse how to balance nutritional needs and manage bloating.
- Other side effects:
Other side effects you may experience are stress and anxiety due to constant medical procedures which lead to depression. Research has also found a possible link between dialysis and dementia later in life.
How to manage them?
Side effects of dialysis like low blood pressure and other heart conditions, occur due to nutrient imbalances during treatment. You can ask for a registered dietitian to create a diet plan according to your dialysis treatment.
Other things you can do to reduce the risk of dialysis side effects include:
- Regularly check your access site to reduce the infection risk.
- Stay physically active by doing low to moderate aerobic exercise, which helps you to reduce weight.
- Drink plenty of fluids or water to prevent dehydration.
- If you have more frequent dialysis sessions, the risk of low blood pressure and weight gain may get lower, according to research.
- Enjoy your favorite activities so that your mood stays better throughout treatment.
While dialysis is a life-saving procedure, it also increases the risk of certain side effects mentioned above. However, you can manage most of them with dietary and lifestyle changes. If you notice any symptoms of low blood pressure, high blood sugar, blood clots, or spreading infection, you should immediately contact your dialysis team or healthcare provider to get timely treatment to manage them.
If you need any help with dialysis treatment, visit our renal clinic in Brooklyn to get professional medical support. Never take any symptoms of kidney problems for granted. It is better to have it checked early on, before it progresses. At Doral Health and Wellness Urology Center, our team of urologists and nephrologists will work with you in managing your disease and your quality of life. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690. You can also visit our website at https://doralhw.org/department/urology/.
