Hemodialysis complications and nursing management

What is hemodialysis and what are its complications? If you have such questions, you have come to the right place.

In this article, we will explain in detail what hemodialysis is, the types of complications, how to prevent them, and much more.

What are the complications of hemodialysis?

Hemodialysis is a life-saving treatment when the kidneys stop functioning. However, it can cause significant side effects and complications.

This is due to the effects of dialysis on blood pressure and heart function.  In addition, these complications are also caused by fluid and electrolyte imbalances in the body.

However, some of the reasons that also cause these complications include not following the dietary restrictions prescribed by the doctor or nurse and not taking adequate amount of fluids.

After explaining these issues, some of the most common complications will be discussed in detail below.


Creating an artificial access point in the body can also cause complications because the closed vascular system is now open. Infection is one of the most common problems associated with the hemodialysis procedure.

The most common symptoms are:

  • Fever and chills.
  • Flatulence.
  • Swelling, redness, and pain.

Remember: Avoid hitting the dialysis access point as this may cause bleeding. If bleeding occurs, there is an increased risk of anemia and vascular aneurysm.


Hypotension, also known as low blood pressure, is one of the complications that can be seen during a hemodialysis procedure.

Both the dose and speed of the procedure remove fluids from the blood and even put internal pressure on the blood vessels, causing the following symptoms:

  • Nausea
  • Muscle spasms
  • Anxiety
  • Discomfort in the abdominal cavity
  • Vomiting
  • Cold, moist skin
  • Blurred vision
  • Dizziness or fainting

Remember: a severe drop in blood pressure can cause serious risks such as heart damage, seizures, and stroke.

Fluid overload

This is also known as hypervolemia. This complication occurs when the kidneys are unable to remove the necessary amount of fluid from the body. In other words, there is an increase in the amount of plasma in the body.

Among the symptoms that can be observed are:

  • Shortness of breath
  • High blood pressure
  • Weight gain
  • Abdominal cramps and bloating
  • Headache

Remember: This complication, if left untreated, can lead to more serious problems such as cardiac arrhythmia, cardiomegaly, and congestive heart failure.

Dialysis imbalance syndrome

Dialysis imbalance syndrome is actually rare. It usually affects people who have just started hemodialysis treatment.

Symptoms of dialysis imbalance syndrome include:

  • Dizziness
  • Headache
  • Weakness
  • Muscle spasms
  • Change in behavior or mental status.

It should be noted that this complication is short-lived. Usually, as the body adapts to the treatment, improvement can be seen.


The hemodialysis procedure removes many electrolytes that the body needs to function properly. However, following a proper diet will not be a problem.

Diabetic patients are an exception, however, because diet is not enough to prevent hypokalemia.

This is because the concentration of potassium in the blood is quite low. As one of the most important electrolytes needed by the body to regulate fluid balance, nerve signals and muscle contractions, it can cause the following symptoms:

  • Weakness
  • Muscle cramps
  • Fatigue
  • Heart palpitations

It is important to remember that in cases of extreme hypokalemia, more serious complications such as cardiac arrhythmias, paralysis, respiratory failure, tearing of muscle tissue, and atrial or ventricular fibrillation can occur.

However, the risk becomes less if the prescribed treatment plan is followed and a fairly strict diet is followed.

What is the nursing management for dialysis?

The purpose and goals of dialysis nurses are to prevent the risk of injury, monitor fluid status, and provide information to both the patient and family members.

Among the nursing tasks, the following basic steps can be identified:

  • Palpate the skin around the access to see if it is warm.
  • Assess if there is pain, tingling, or numbness.
  • Handle the tube properly to avoid injury.
  • Observe blood color and separation of cells from serum.
  • Notify the physician if complications occur.
  • Avoid contamination of the access site.
  • Monitor temperature for fever, chills, or hypotension.
  • Appropriate administration of medications.

How can you prevent hemodialysis complications?

Prevention of complications requires care from the patient, nephrologist and dialysis team.

Proper treatment, hygiene and diet will certainly help prolong the health and well-being of the patient.

Some of the recommendations for preventing complications are:

  • Conscientiousness in the management of dialysis. Failure to follow this recommendation may lead to complications.
  • Always stay in contact with the doctor and nurse.
  • Hygienic hand disinfection.
  • Cleanliness of all equipment, machines and surfaces.

Vaccines to prevent infections

People with kidney disease are generally at high risk for infections because their immune system is impaired.

For this reason, vaccinations are required as a protective and preventive measure against infectious diseases.

Recommended vaccinations include:

  • Influenza vaccines.
  • Hepatitis B.
  • Pneumococcal.
  • Tetanus


In conclusion, the hemodialysis procedure must be performed with great care to prevent the complications mentioned in the article.

Although it is a quick method of removing waste from the blood, it must go hand in hand with doctor’s recommendations, strict diet and proper hygiene. Following the list of recommendations will lead to well-being and long-term health.


Marlene J. Shockley

My name is Marlene J. Shockley, and I am a Registered Nurse (RN). I have always been interested in helping people and Nursing seemed like the perfect career for me. After completing my Nursing Degree, I worked in a variety of settings, including hospitals, clinics, and home health care. I have also had the opportunity to work as a Travelling Nurse, which has allowed me to see different parts of the country and meet new people. No matter where I am working, I enjoy getting to know my patients and their families and helping them through whatever medical challenges they may be facing.