What Are the Potential Complications of Hemodialysis?

Complications of hemodialysis are numerous and depend on which access method is used. General complications can include nausea, fatigue, and leg cramping. Long-term complications can include neuropathy, amyloidosis, and aneurysms.

Hemodialysis is a process that removes waste products, such as urea or creatine, from the blood supply of the body when the kidneys are not functioning properly. When the kidneys stop filtering out waste, the condition is called renal failure. Without filtering, the body accumulates these wastes and additional fluid, which can be fatal and cause other organs to stop functioning well. There are three ways to access the blood for filtering through a dialysis machine.

Venous catheters, also sometimes called implanted intravenous (IV) lines, are used to provide quick access when hemodialysis is necessary and immediately needed to prolong life. Two lumens are attached to separate tubing. One tube draws blood from a large vein through one of the lumens that has been inserted, and the blood travels through the tube into the dialysis machine. When the filtering is finished, the clean blood is sent through the second tube into the second lumen and returned to the body’s circulation. Complications of hemodialysis through catheter use include infection and venous stenosis, which causes the veins to narrow and develop scarring.

An arteriovenous (AV) fistula is the surgical joining of a vein and artery, and is a common method chosen for patients who are dependent on long-term hemodialysis. The AV fistula provides direct access to the blood, and bypasses the capillaries to increase blood flow. Two IV lines are inserted through the skin and into the fistula. One line draws the blood to be filtered and the second line returns the clean blood. Complications of hemodialysis with a fistula include aneurysms, cramps, and tissue damage.

AV grafts are similar to fistulas, but a graft uses artificial vessels to join the vein and artery. These grafts are used as an alternative to fistulas, primarily for patients with small or damaged veins. Complications of hemodialysis using grafts include blood clots and infections.

General complications of hemodialysis are often temporary. Due to the overall process, patients may experience headaches, a blood pressure drop, nausea, and fatigue. These complications often coincide with the rate of fluid removal. In some cases, patients may develop infections or experience an enlarged heart as a result of an overload of fluid.