arising from dialysis treatment
Last reviewed 01/2018
These include:
- hypotension - from removal of fluid and alterations in electrolyte balance. It is more common in:
- the elderly
- diabetics with peripheral neuropathy
- patients with pre-existing vascular disease
- patients receiving anti-hypertensive treatment
- anaphylactic reactions - from modest respiratory distress to anaphylactic shock; especially with cuprophane membranes
- hypertension - from salt and water retention. It is more common in:
- patients prone to hypotension during dialysis - because of difficulty in obtaining adequate asymptomatic fluid loss during dialysis
- poor compliance with salt and water restriction
- hyperkalaemia - from poor dietary compliance
- amyloidosis - possibly from activation of inflammatory mediators during extracorporeal circulation
- infection - from microbial contamination of vascular access points and the extracorporeal circulation. Gram positive bacteria are common. There is an increased incidence of hepatitis C
- malnutrition - causes include:
- loss of amino acids and peptides in the dialysate
- sodium restriction and poor palatability of diet
- dialysis induced hypercatabolism
- social and psychological factors
- aluminium intoxication
- from inadequate filtration of incoming water supply - this is now rare
- use of calcium-containing phosphate binders - there is study evidence of a higher mortality associated with use of calcium-containing phosphate binders in haemodialysis patients (1)
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