Dialysis may cause various side effects, including fatigue, infection, and itchy skin. A doctor can recommend ways to help ease symptoms or adjust treatment as necessary.

Dialysis is a treatment necessary to prolong the lives of people with advanced kidney disease. There are two types of dialysis – peritoneal dialysis (PD) and hemodialysis (HD). Both work differently and may lead to the same and different side effects.

Doctors can help prevent and manage side effects to reduce the risk of long-term complications.

This article will review the side effects of HD and PD, how to manage and improve them, and when to contact a doctor.

Dialysis tubes -1.Share on Pinterest
Science Photo Library/Getty Images

Peritoneal dialysis (PD) involves using the lining of the abdomen as a filter to clean the blood inside the body.

Some side effects of PD include the following:


PD can increase the risk of developing a hernia. Hernias may occur due to strain in the abdominal muscles from retaining fluid in the peritoneal cavity for prolonged periods. A lump may form in the affected area.

Many people may not know they have a hernia, and the lump may only appear while they are doing certain activities, such as coughing or bending over. To repair a hernia, people typically need to undergo surgery.

Surgery involves placing the displaced tissues back inside the abdominal wall. A surgeon may install a synthetic mesh to help strengthen the abdominal wall and prevent a new hernia from developing.

Weight gain

PD involves using dialysate fluid, which contains sugar molecules. According to the National Health Service (NHS) in the United Kingdom, the body absorbs some of these molecules, which may mean a person will exceed their daily calorie intake — usually by a few hundred calories. A person might gain weight if they do not compensate by reducing their caloric intake.

Doctors and dieticians can recommend the most appropriate diet plan to support the body with essential nutrients while losing or maintaining weight. Avoid diets that make claims about losing weight quickly, as this may cause issues with dialysis or potentially severe illness.

HD involves using a blood filtering machine. A person will require HD treatment three times a week at a dialysis center.

Some side effects of HD include the following:

Pain from inserting the needle

HD involves inserting a needle into the arm and connecting it to the tube of the dialysis machine. Sometimes, needle insertion can cause pain. However, the pain usually subsides after a few minutes.

Low blood pressure

Low blood pressure, or hypotension, is one of the most common side effects of HD. This may be due to the sudden drop in fluid levels during dialysis.

Hypotension may cause symptoms such as dizziness and nausea. Good hydration and reintegrating fluids can reduce the symptoms of low blood pressure.

However, if the symptoms persist, a person should speak with the dialysis care team, as it may mean that doctors adjust a person’s dialysis treatment plan. For example, they might be able to reduce the amount of fluid used during dialysis.

Muscle cramps

People may develop muscle cramps during HD. The cramps typically develop in the lower leg but can occur anywhere in the body.

Muscle cramps may occur as a reaction to the fluid loss during HD. Doctors may provide medications to improve particularly painful cramps.

Other side effects

HD may cause other side effects, such as:

Doctors can recommend the most effective treatment to improve these symptoms. Sometimes, they may recommend changes to the treatment plan or a person’s lifestyle.

There may be an overlap in certain symptoms for people undergoing either PD or HD. These can include:

Tiredness and fatigue

While fatigue can affect anyone, it is more common in people who have undergone dialysis for a long time. A combination of factors may contribute.

People undergoing HD may be more tired on dialysis than on rest days.

The NHS indicates that low to moderate-intensity exercise, such as walking or cycling, may help overcome fatigue. A doctor can best advise on what type of exercise is suitable.


Peritonitis refers to a bacterial infection of the peritoneum or the lining of the abdomen. It is a common side effect and can occur with both dialysis types.

Peritonitis may occur if the dialysis equipment is not clean. Bacteria can live on dialysis equipment, breed, and potentially spread to the peritoneum.

The most effective step a person can take to prevent peritonitis is to keep their dialysis equipment clean. If a person has peritonitis, they may experience symptoms such as:

  • high fever
  • abdominal pain
  • feeling and being sick
  • chills

The used dialysis solution may also appear cloudy.

Anyone undergoing PD or HD who develops these symptoms should contact a doctor immediately. Doctors may prescribe injections of antibiotics to treat the infection.

A person having PD may have to switch to HD if they experience severe or recurrent infection.

Risk of sepsis

HD or PD can increase the risk of blood poisoning, also known as sepsis. This happens when bacteria enter the bloodstream and spread throughout the body. Peritonitis can lead to sepsis if left untreated.

Sepsis can potentially cause multiple organ failure and be life threatening.

Symptoms of sepsis may include:

  • high fever
  • sweaty, clammy skin
  • a rash that does not fade when rolling a glass over it
  • dizziness
  • confusion
  • difficulty breathing

Anyone undergoing dialysis and has a high temperature should contact a doctor as soon as possible. A person who develops sepsis symptoms must seek urgent medical attention.

Doctors may need to hospitalize a person with sepsis and give them antibiotic injections.

Itchy skin

HD and PD may cause itchy skin, but it is often difficult for someone to determine if this is a side effect of dialysis or symptoms of long-term kidney disease.

Still, a doctor may recommend topical creams to soothe and moisturize the skin, improving the itchiness.

A person undergoing any dialysis type should contact a doctor if they develop a high fever. If they experience any symptoms of sepsis, urgent medical attention is essential.

Long-term kidney disease or prolonged dialysis treatment can affect a person’s mental health. Speaking with a healthcare professional about any concerns about overall health during dialysis treatment dialysis can be beneficial.

Mental health resources

Visit our dedicated hub for more research-backed information and resources on mental health and well-being.

Was this helpful?

People undergoing PD may experience side effects such as weight gain, hernia, and peritonitis. A person who undergoes HD may notice side effects such as low blood pressure, muscle cramps, and itchy skin. Various other side effects may occur with both treatment types.

In some more severe cases, people can develop sepsis, a serious blood infection.

If a person who regularly undergoes dialysis develops high temperature or any symptoms of sepsis, they should immediately contact a doctor.