Common problems during hemodialysis

Fatigue, low blood pressure, dark skin, itching, cramps, difficulty sleeping, and joint pain are common problems that patients encounter during hemodialysis.

Dr. Ho Tan Thong, Department of Nephrology - Dialysis, Center for Urology - Nephrology - Andrology, Tam Anh General Hospital, Ho Chi Minh City, said that hemodialysis is one of the methods to maintain life for patients with end-stage renal failure. During the early stages of hemodialysis, patients may encounter the following problems:

Hypotension : This is a symptom related to rapid reduction of blood volume during dialysis without adequate fluid replacement. When blood pressure drops, most patients feel dizzy and lightheaded, but there are also cases where there are no symptoms until blood pressure drops to a low level. Therefore, patients need to have their blood pressure monitored regularly, every 30-60 minutes.

Cramps : The cause of cramps during hemodialysis is currently unknown, but is related to low blood pressure, electrolyte imbalance in the body (low magnesium, potassium, calcium in the blood), and inadequate fluid replacement. In addition to treatment by a doctor, the patient or family member can massage the cramped muscle to reduce this condition during dialysis.

People undergoing dialysis at Tam Anh General Hospital in Ho Chi Minh City. Photo: Thang Vu — People undergoing dialysis at Tam Anh General Hospital in Ho Chi Minh City. Photo: *Thang Vu*

Itching : This condition often occurs due to the patient being allergic to the filter membrane, dialysis equipment or due to the accumulation of minerals (calcium, phosphorus) in the body through dialysis sessions. Patients need to inform the doctor about the itching condition to find the cause and treat it appropriately.

Anemia : In patients with end-stage renal failure, the kidneys no longer produce hormones involved in the process of blood cell (red blood cell) production, leading to anemia. In addition, dialysis removes iron and vitamins necessary for blood production, increasing the risk of anemia.

Difficulty sleeping: People on long-term hemodialysis often have difficulty sleeping because they may experience problems such as body aches, restless legs syndrome, and sleep apnea.

Fatigue : After dialysis, patients are often tired and exhausted due to many reasons such as severely reduced kidney function, side effects during dialysis, and inappropriate diet leading to malnutrition.

Osteoarthritis : Decreased kidney function affects the body's ability to absorb and convert vitamin D into calcium, leading to osteoporosis. In addition, another common complication in people on long-term dialysis is secondary hyperparathyroidism (increased production of PTH hormone) which will mobilize calcium from the bones into the blood, causing osteoporosis and porous bones.

Doctor Thong said that the current HDF online hemodialysis technique is an improvement from conventional hemodialysis with a more effective filter membrane, using purified water, helping patients reduce many of the above side effects, improving health and quality of life.

Doctor Thong advises that people on dialysis who experience fatigue, itching, low blood pressure, anemia, osteoporosis, difficulty sleeping, etc. should see a nephrologist for examination, to determine the cause, and receive appropriate treatment to ensure their health.

Thang Vu

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