• Low Blood Pressure

Hypotension is the most common acute complication during dialysis. Generally, it is caused by excessive and rapid dehydration. When the blood pressure is lower than 90/50mmHg, various symptoms of hypotension will appear.


For example, yawning, chest tightness, dizziness, palpitations, nausea, dyspnea, cold sweats, cold limbs, unconsciousness, etc., call the medical staff immediately.

 


Common Cause


1. The amount of ultrafiltration is too much, and the ultrafiltration speed is too fast.


2. There is malnutrition, anemia and hypoalbuminemia.


3. Heart, brain, kidney and systemic vascular sclerosis, weakened vasoconstriction.


4. Autonomic dysfunction.


5. Inappropriate use of antihypertensive drugs.

 

Preventive Solution


1. During the dialysis period, the body weight should not increase too much, and it is best to control it within 3%-5% of the dry body weight.


2. When the weight gain is too much, the dialysis time or dialysis frequency should be appropriately increased.


3. Strengthen nutrition, correct anemia and hypoalbuminemia.


4. Use low-temperature dialysis, and set the dialysate temperature to 35-36°C.


5. Kidney friends with repeated hypotension during dialysis should stop taking antihypertensive drugs or reduce the amount of antihypertensive drugs on the day of dialysis.


6. When there is a trend of hypotension, lower the head and raise the feet so that the height of the legs and feet is higher than the head.


7. Immediately call the nurse, add normal saline and stop dialysis if necessary.

 

 

  • Dialysis Imbalance Syndrome

Imbalance Syndrome, an increasingly rare syndrome that usually appears on the first dialysis, is caused by the removal of blood urea nitrogen too quickly and too slowly from the brain cells, causing water to migrate to the brain, causing cerebral edema .


Generally appear shortly after dialysis, nausea, vomiting, headache, convulsions, fatigue, confusion and other nervous system symptoms will occur.

 


Preventive Solution


1. Try to use a dialyzer with a small dialysis membrane area to slow down the blood flow (150-200ml/min).


2. Dialysis once a day, two hours each time, continuous dialysis for 3-4 days.


3. Call a nurse and administer medication if necessary.

 

 

  • Muscle Cramps

Muscle spasm is also a common discomfort during dialysis, mainly in the calf, abdomen, and waist. Patients often get off the machine early because they cannot bear it, resulting in insufficient dialysis.

 

Common Cause


1. Too much and too fast ultrafiltration during dialysis; resulting in insufficient circulating blood volume, vasoconstriction of extremities, and muscle ischemia causing spasms.


2. The setting of dry weight is unreasonable and excessive dehydration.


3. The sodium concentration of the dialysate is too low, <135mmol/l.


4. Hypocalcemia, resulting in hypocalcemic convulsions.

 

Preventive Solution


1. Kidney friends without edema and high blood pressure can try to increase their dry weight by 0.5kg.


2. Maintain a stable weight gain between dialysis at 3%-5%, or extend the dialysis time.


3. Follow the doctor's advice to use levocarnitine, vitamin E and other drugs.


4. In case of muscle spasm, perform appropriate massage and hot compress to relieve it.

 

 

 

  • Arrhythmia

Arrhythmia is related to blood pressure, blood potassium level, anemia, dialysis age, underlying heart disease, etc. It is one of the common causes of sudden death during dialysis.


People with high blood pressure, low blood pressure, anemia, abnormal blood potassium, old age and coronary heart disease are more likely to have kidney disease, and urgent treatment is necessary when malignant arrhythmia occurs.

 


Preventive Solution


1. Kidney friends with hyperkalemia, control potassium intake to avoid hyperkalemia.


2. Kidney friends with low blood potassium should eat properly during dialysis to prevent hypokalemia after dialysis.


3. Keep blood pressure stable and actively treat renal anemia.

 

 

  • Abdominal Pain

Abdominal pain during dialysis is also very painful. It is often caused by dialysis complications and occurs during or after dialysis. But pay attention to distinguish it from abdominal pain caused by other reasons.

 

Common Cause

 

1. Hypotension or excessive or rapid dehydration lead to insufficient blood supply to the gastrointestinal tract, ischemia, hypoxia, and convulsions.


2. Hypoglycemia, when the blood sugar drops, the sympathetic nerves are excited, causing acute abdominal pain.


3. Gastrointestinal discomfort caused by eating too much, too cold, or greasy food during dialysis.

 

Preventive Solution


1. Avoid hypotension during dialysis.


2. Eat in moderation during dialysis and avoid excessive and greasy food.


3. When hypoglycemia occurs, give 50% glucose 40ml intravenously, or 10% glucose water 200ml intravenously or orally.

 

 

  • Bleeding

Heparin is routinely used during dialysis and bleeding is prone to occur. Especially when the platelets are low and there is certain bleeding before dialysis, such as gastrointestinal bleeding (black stool), hemorrhoid bleeding, nose bleeding, etc.

 

Common Cause


1. Poor platelet function


2. Use of heparin


3. High blood pressure


4. Peptic ulcer

 

Preventive Solution


1. Reduce or stop using heparin


2. Avoid eating too much during dialysis


3. Appropriate pressure on the pinhole after dialysis to ensure hemostasis