Complications of Dialysis



Clotting or infection of the vascular access is a common problem in patients maintained on he­modialysis. In addition, the hemodialysis ma­chine functions as a low-resistance arteriovenous fistula, requiring that cardiac output and/or pe­ripheral vascular resistance increase so as to maintain systemic arterial blood pressure. In pa­tients with significant heart disease or autonomic neuropathy (particularly diabetics) or those re­ceiving drugs that inhibit the normal response of the autonomic nervous system, failure to manifest the appropriate cardiovascular response may re­sult in intolerance to hemodialysis. The changes in extracellular fluid volume and in the composi­tion of blood following hemodialysis may also contribute to the patient’s intolerance to hemo­dialysis. Peritonitis is the most common compli­cation of peritoneal dialysis and occurs following the inadvertent introduction of bacteria into the peritoneal space through the peritoneal dialysis catheter. Infections may also occur along the intra-abdominal tract of the catheter. In patients on peritoneal dialysis for extended periods (years), there may be a progressive loss in the ef­ficiency of dialysis.





Complications of Dialysis