What are the side effects of a hemodialysis? Joe Cosgrove asks himself. What changes do people experience when they are treated with Hemodialysis? In fact, what can patients expect when the treatment starts and all the changes in the body start to appear? Let’s first take a look at what causes a body to receive a hemodialysis and what it does to the body.
Chronic kidney disease and acute kidney injury (also known as acute renal failure) cause the kidneys to lose their ability to filter and remove waste and extra fluid from the body. Hemodialysis is a process that uses a man-made membrane, known as a dialyzer to remove wastes, such as urea, from the blood; restore the proper balance of electrolytes in the blood and eliminate extra fluid from the body.
For hemodialysis, you are connected to a filter (dialyzer) by tubes attached to your blood vessels. Your blood is slowly pumped from your body into the dialyzer, where waste products and extra fluid are removed. The filtered blood is then pumped back into your body. There are different types of hemodialysis such as In-center hemodialysis where you go to a hospital or a dialysis center; home hemodialysis which comes after you are trained and you do your dialysis treatments at home; daily home hemodialysis and nocturnal home hemodialysis.
Ok, but what are the real changes or consequences our body feels when it goes through hemodialysis treatments? Here they are:
- Low blood pressure (hypotension). One of the most common side effects of a hemodialysis is a drop in blood pressure, particularly if you have diabetes. Low blood pressure in turn causes many other factors to change. For example, all this can come with shortness of breath, abdominal cramps, muscle cramps, nausea or vomiting. If the patient also suffers from diabetes, these problems will appear even faster.
- Muscle cramps. If they occur, nobody knows why they occur during Hemodialysis, they usually happen in the last half of a dialysis session. The cramps can be stopped by adjusting the hemodialysis prescription and adjusting fluid and sodium intake between hemodialysis treatments.
- Sleep problems. People receiving hemodialysis often have trouble sleeping, sometimes because of breaks in breathing during sleep (sleep apnea) or because of aching, uncomfortable or restless legs. It is extremely common for dialysis patients to have sleep disturbances, which can affect daytime alertness, activity level, and overall well-being. There is a study done by Havva Tel, PhD; Hatice Tel, PhD; and Mehtap Esmek, RN called Quality of Sleep in Hemodialysis where they found that as age increased in patients, sleep quality decreased. They also found that elderly men are more likely to have sleep problems. “Advanced age and long-term dialysis therapy directly affected patients experiencing sleep problems”.
- Anemia. Not having enough red blood cells in your blood (anemia) is a common complication of kidney failure and hemodialysis. When kidneys are diseased or damaged, they do not make enough EPO. As a result, the bone marrow makes fewer red blood cells, causing anemia. When blood has fewer red blood cells, it deprives the body of the oxygen it needs. In a hemodialysis treatment, a lot of blood is lost and recovered and this causes anemia as well. When kidneys fail and a hemodialysis takes place, nutrients such as iron, vitamin B12 and folic acid will start to scarce, causing anemia too because they are the nutrients responsible of making red blood cells to make hemoglobin, the main oxygen-carrying protein in the red blood cells.
- Bone diseases. Bone diseases come in a hemodialysis treatment because after you have had chronic kidney disease and you are doing the treatment, the body, more specifically the kidney, cannot process vitamin D, and in turn cannot absorb calcium. As a consequence, your bones may weaken. Also, calcium is released from the bones because the treatment and kidney failure causes overproduction of the parathyroid hormone.
- High potassium levels (hyperkalemia). One of the functions the kidney has is to remove Potassium from the body and the blood. If you eat more potassium than recommended, your potassium level may become too high. It can sound a little extreme, but it has been known that too much potassium can cause your heart to stop.
- Depression. And of course, the last and silent disease. People do not like to be ill and especially from the kidney which gives you that line of defense. Changes in mood are common in people with kidney failure and some people don’t emotionally react very well to the situation. The best idea is to talk with the health care team about options to treat depression.
It is good to know what will inevitably come from our health treatments. Sometimes avoiding these effects is not an option, but it is an option to be informed and adapt the best way possible.