People suffering from renal failure who must experience dialysis sessions know that it is not a pleasant experience. Although this procedure lengthens their life, side effects may occur they should know them in advance for minimizing them, in some cases, in order to completely avoid them.
Sessions are tough. Each process lasts four hours, and it’s three times a week. Sometimes it is not easy to hold. Renal patients should be connected to the machine to successfully clear their blood. The hemodialysis machine collects the toxic substances from the blood stream through an efficient filter that cleans it and injects it back again.
During that process, some alterations may be present in the patient’s body: the blood pressure suddenly changes, some cramps may occur, an overload of fluids sometimes, numbness in legs and arms, etc. Some of the most common side effects are nausea (sometimes with vomit), itching, headaches, and involuntary muscle movements, like nervous tics. This, without considering problems that may take place with fistulas, needles or bleeding.
To this extent, it is perfectly normal that patients get exhausted after each session. It is normal to feel weak and shaky. Obviously, everything may differ in intensity every time, or, in some cases, they may even not occur. Remember that every organism is different and shows different reactions.
Because of the normal side effects, doctors recommend rest after dialysis sessions. Physical exercises or tasks that require concentration, such as driving, can bring adverse outcomes. After an hour (though it’s variable for each patient), everyday tasks can be performed normally, even those requiring efforts, such as sports or some physical work. The important thing is to keep a positive attitude and remembering that the sensations produced as side effects are transitory.
Actually, doctors often recommend performing physical activities during the days in which the patient should not attend dialysis sessions. It is well-known that physical exercise enhances the beneficial effects of dialysis and reduces the side effects. However, it is important that the patient doesn’t perform extremely intense activities (extreme sports, for example) and, on the other hand, in all circumstances patients must protect the limb vascular access.
It is normal to leave a dialysis session with a little less weight because the liquid excess is removed from the body. A possible side effect is to finish the session with less weight (more than the expected amount) and then suffer from hypotension, extreme fatigue, and severe muscle cramps. Therefore, it is important to consume the amount of liquids that doctors recommend (not more, not less.) “Between dialysis sessions, patients should not drink more than two liters of liquid because it would increase their overweight significantly and would bring several difficult problems that could be avoided by following this simple advice,” says Joe Cosgrove, Chairman, President and CEO of Pentec Health.
The reactions of patients are mainly due to the awareness of their bodies to ethylene oxide and to the cellulosic membranes which are not biocompatible (cuprophane or its derivatives, for instance). Nevertheless, there may be more sensitive reactions during the dialysis session that the already described above, and they happen due to other substances in the dialysis process, such as an anaphylactic allergy because of polysulfone biocompatible membranes.
This kind of reactions usually begin within a few minutes into the hemodialysis; immediately after contacting the blood dialysis circuit with the patient’s body. In some cases, the reaction may be delayed more than half an hour from the beginning of each treatment. More severe reactions can cause shortness of breath, loss of consciousness, hypotension, cardiac arrest and even death.
Traditionally adverse reactions happen in four out of approximately 100,000 dialyses. It is known that one in twenty to one in fifty patients could be susceptible to present an anaphylactic reaction with a new dialyzer simultaneously, while the risk of reaction in a single dialysis is approximately one in 1000 to one in 5,000. These reactions are not related to a particular type of membrane, a particular dialyzer, a particular dialysis technique or a priming procedure, but in those few patients suffering from repeated reactions, the problems can be avoided by increasing the volume of salt in the wash initial dialyzer or by simply changing the type of membrane.
Finally, other side effects that can occur (actually more unpredictable), are related to the mental health of patients. Several patients who undergo hemodialysis have symptoms of depression. In many cases, there suffer from panic attacks and the anxiety and stress levels may increase a lot. The first thing to consider is that these reactions are normal due to chemical changes in the bodies of patients and stress levels produced by long sessions. It is best to visit a psychiatrist who is aware of the dialysis treatment, to avoid a dangerous deterioration in the mental health of the patient.