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Managing the side effects of dialysis: fatigue, fluid balance and common discomforts34,36
Living with chronic kidney disease and undergoing dialysis treatment can lead to several side effects that affect everyday life. Among the most common are fatigue, fluid imbalances, pain and numbness, dry and itchy skin, and feelings of dizziness or discomfort. Fortunately, there are ways to better manage these symptoms and improve daily comfort.
Fatigue: Understanding and anticipating It
Fatigue related to dialysis is common and may be caused by several factors:
- The rapid removal of toxins during in-centre dialysis sessions, which can lead to a feeling of exhaustion.
- Blood pressure fluctuations during or after dialysis.
- Anaemia caused by insufficient erythropoietin production by the kidneys.
- Nutritional deficiencies affecting energy levels and muscle recovery.
How can fatigue be reduced ?
- Pace your activities: organise your day by alternating periods of rest with moderate physical activity, such as walking, which can help restore energy.
- Optimise your nutrition: sufficient protein and iron intake can help combat anaemia and support recovery.
- Maintain good sleep habits: establish a calming bedtime routine and avoid screens before sleep.
- Speak with your nephrologist: treatment adjustments, including erythropoietin injections, may be needed to manage anaemia.
Fluid imbalance: maintaining healthy fluid management
Managing excess or restricted fluid intake is a recurring challenge in dialysis. Excess fluid can lead to swelling, high blood pressure and breathing difficulties, while removing fluid too quickly may cause low blood pressure, cramps and headaches.
How can fluid balance be better managed ?
- Monitor fluid intake: limit drinks according to medical advice and choose water-rich foods (fruit and vegetables) to help control thirst.
- Reduce salt intake: a low-salt diet can decrease thirst and limit fluid retention.
- Weigh yourself regularly: monitoring weight helps identify excessive fluid gain between sessions.
- Consider more frequent dialysis: shorter, more frequent sessions can reduce fluid build-up and may be better tolerated by the body.
Pain and Numbness: how to relieve them ?
Many dialysis patients experience muscle or joint pain, as well as numbness, particularly in the legs and hands. These symptoms may be linked to poor circulation, electrolyte imbalances or overly aggressive dialysis sessions.
Tips to help relieve these symptoms:
- Gentle stretching and massage can improve circulation and reduce cramping.
- Adjusting your position during dialysis may help prevent prolonged nerve compression.
- Check calcium, potassium and magnesium levels with your nephrologist, as imbalances can contribute to cramps.
- Apply warm or cold compresses to painful areas depending on which provides the most relief.
Dry Skin and Itching: Prevention and Relief
The build-up of toxins in the body and the loss of certain essential substances can dry the skin and cause intense itching, significantly affecting quality of life.
How can you care for your skin?
- Moisturise daily using a fragrance-free cream rich in soothing ingredients such as aloe vera or urea.
- Avoid very hot showers, which can further dry the skin.
- Wear cotton clothing to reduce irritation.
- Limit foods high in phosphorus (dairy products, fizzy drinks, processed meats), which may worsen itching.
- Consult your doctor if itching becomes severe and requires treatment.
Feelings of dizziness or discomfort: preventing low blood pressure and unease
During or after dialysis, some patients may experience dizziness, cold sweats or sudden weakness. This is often related to a drop in blood pressure or overly rapid fluid removal.
How can these sensations be limited?
- Stand up slowly after dialysis to avoid sudden drops in blood pressure.
- Have a light snack before or after the session to prevent low blood sugar.
- Inform your healthcare team of any discomfort so the filtration rate can be adjusted if necessary.
- Avoid sudden changes in position that may trigger dizziness.
By following these recommendations and maintaining regular communication with your healthcare team, it is possible to improve daily comfort and live better with dialysis.
It is also important to know that different dialysis options exist, some of which may be gentler on the body, such as home dialysis.
Because home dialysis allows for more frequent and better-distributed sessions, it may help reduce certain side effects such as fatigue and fluid imbalances. However, it also comes with additional responsibilities, including greater independence in managing treatment.
Discussing these options with your nephrologist can help you choose the solution best suited to your lifestyle and health condition.