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Fluid (water) Gain

Fluid gain is caused by a decrease in urine flow and a normal to increased intake of dietary fluids. Fluid gain is measured by weighing you before each dialysis treatment begins. Fluid gains between dialysis treatments should not be more than 2 lbs. each day.

Large fluid gains may make treatment uncomfortable and can result in:

  • Swelling in the tissue, called edema. This is seen most often in the feet, ankles and around the eyes
  • Abdominal bloating;
  • Shortness of breath due to fluid in the lungs
  • Increase in blood pressure due to extra fluid in the blood stream
  • Lead to more serious problems


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High Blood Pressure

High blood pressure can be a primary medical problem that will need to be controlled by medication and diet. It can also be caused by too much fluid gain between dialysis treatments.

Signs of high blood pressure may or may not be present but can include:

  • Headache
  • Nausea
  • Dizziness and blurred vision

To prevent high blood pressure it is very important to follow your physician’s directions and take your medication as prescribed.


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Itching

Itching of the skin, scalp, or eyes can be caused by an inadequate removal of a waste product, called urea, or a build up of phosphorus in the blood stream. Dialysis treatments remove urea.

Phosphorus is an element found in many foods that is normally discharged by the kidneys. In kidney failure, phosphorus in the diet must be limited. You must not only limit the phosphorus in your diet but you must also remove the extra phosphorus in your body. The extra phosphorus is taken away by drugs called phosphate binders that you must take with every meal. Extra phosphorus can cause itching; some creams applied to the skin can give some soothing and relief.


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Leg/Muscle Cramps

You may experience leg or muscle cramps during or after your dialysis treatment. Rapid changes in salt and fluids in your blood stream during the dialysis procedure may cause this. You should tell your caregivers if you are experiencing cramping during your treatments and they can adjust your dialysis prescription to decrease these symptoms. Exercise and medications can also provide some relief. You can help by following the fluid limits in your diet.


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Low Blood Pressure

Low blood pressure is most often experienced during and after treatments. This is due to rapid removal of fluid from the blood stream. During treatment the nurse can give normal saline solution to help raise your blood pressure.

You can help by:

  • Avoiding excessive fluid weight gains between dialysis treatment
  • Telling your nurse if you are on any new medications
  • During your treatments telling your care giver immediately if you feel light-headed, nauseous, sweaty or have blurred vision
  • Know what your normal blood pressure is and what you begin to feel like when your blood pressure gets too low


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No Appetite

Appetite should improve with good dialysis. If it does not improve once treatments begin let your physician or dietitian know. A consistently poor appetite may be due to other problems or from medication you are taking.


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Weakness, listlessness, tiredness

These symptoms should also improve once you are receiving adequate dialysis treatment. Some of these symptoms can be from a low blood cell count called anemia. This will be helped with the administration of a drug called Epogen®. An exercise program that increases circulation and muscle strength will also help decrease these symptoms. It is important to communicate with your physician and nurse if you are experiencing these symptoms over time. Pay close attention to your blood count by knowing your hemoglobin level. A hemoglobin level of 11-12 gm is recommended to avoid the symptoms of anemia.


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Frequent needle sticks

Frequent needle sticks cannot be totally avoided if you are on three time a week hemodialysis. However as your dialysis access becomes stronger you should expect the 2 needle sticks with each treatment to be quick and uncomplicated. When dialysis access is new it is often immature and fragile; needle sticks may be more difficult. This will improve as the access matures and the blood vessels get stronger.

Steps you can take to keep needle sticks to a minimum include:

  • Care of your access arm, including limiting use for dialysis only
  • No tight clothing or jewelry on the access arm and no blood pressures to be taken on that arm
  • Follow any recommendations from your physician or nurse for exercise that will help your access to mature faster
  • Keep your access arm clean, wash thoroughly before each dialysis treatment


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Sexual Functioning

An increase in sexual function may occur once your overall health status improves with dialysis treatment. Sexual function depends on both physical and psychological factors and may benefit from medications or counseling. You should feel comfortable to discuss your sexual concerns with your physician or social worker.


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