Common side effect dialysis

1. Low blood pressure --> nausea and dizzy

Too much fluid between treatments / too much fluid

is removed during dialysis.

Follow intake fluid recommendation, avoid salty food

to make you thirsty.

2. Nausea - vomiting

Regulate fluid removal and anti nausea

Assess abdominal pain and constipation

FR : Gylcemic, fluid, opioid, tramadol, iron sup, SSRI,

bupropion, phosphate binder, inadequate, constipation

Non Farmako : less spicy, strong smell and high fat

food, snack, head up 30 - 60 min after meals, good
oral hygiene, cool cloth on neck or forehead

Farmako : Haldol (0,25 - 0,75 mg BID or TID),

methotrimeprazine (2 - 5 mg TID), ondansentron (4
- 8 mg BID), metoclopramide (5 mg QID),
domperidone (5 - 10 mg TID), dimenhydrinate.

3. Dry or itchy skin

P and K

P binder, non drying soaps, moist lotion

 Avoid fragrance lotion, hot shower

4. RLS

Vit B deficiency

Massage, warm bath, compresses, exercise, relaxation

5. Muscle cramp

Quick loss fluid

Stretching, hot packs

6. Sepsis

Dizzy and high temperature ≥ 38 C

Antibiotic

7. Insomnia / staying asleep

8. Bone and joint pain

9. Dry mouth

10. Anxiety

11. Headache

Bifrontal discomfort, nausea without vomiting, no

visual disturbance

2 of : in dialysis, worse intra dialysis and resolve after

72 hours
 Caused by caffeine withdrawal, hypo/hypertension,
hard water syndrome (high Ca or Mg in dialysate), F
intoxicate, Chloramine intoxicate.

Prevent by paracetamol, slow Qb, sodium profile, UF

profile, coffee, reuse

12. Disequilibrium (brain edema)

Headache, nausea without vomiting, dizziness, muscle

cramp, blurred vision, tremors, restlessness, agitation,
agitation, alteration, seizure, coma, sudden cardiac
arrest.

Develop after until 24 hours dialysis complete

RF : high ureum, aggressive urea removal (> 30 %),

children, pre-existing neurological impairment,
metabolic acidosis

Manage : slow initial (2 hours, Qb 200, low dialyzer,

high sodium 143 - 146, dextrose IV)

13. Sudden cardiac arrest

60 % risk of it

Based on CAD, electrolyte shift, LVH, abnormal

myocard

14.