Intradialytic complications of hemodialysis

Abstract

Aim of study: To study the intradialytic complications of hemodialysis. Methods: 275 patients of renal failure comprising of 125 acute renal failure and 150 chronic renal failure patients who were registered for conventional hemodialysis during the period of May 1, 2007 and May 15, 2008 were taken up for the intradialytic complications of hemodialysis regardless of age, sex,race and cause of renal failure. Special emphasis has been given for complications related to vascular access sites like femoral, arterio-venous and internal jugular venous punctures. During the study period there were 1075 bicarbonate dialyses on these patients. Most of the ARF and CRF patients were dialysed by femoral vein access. Among the patients on CRF, 10 patients were on arterio-venous fistula and 8 were on internal jugular venous catheterizations. Results: In the ARF patients, common intradialytic complications were hypotension (12.2%), vomiting (5.2%), headache (5.2%), rigor (2.4%), hypertension (1.2%), nausea (1%), cramps (0.8%), oedema (0.9%), fever (0.6%), first-use syndrome (0.4%), hypoglycemia (0.4%), and itching (0.2%). In the CRF group, common complications were hypertension (11.4%), hypotension (10.48%), vomiting (8.7%), rigor (5.7%), chest pain (4.6%), nausea (3.1%), headache (3.1%), fever (1.6%), cramps (0.71%), itching (0.35%) and haematoma (0.35%). Intracerebral hemorrhage and migration of fractured catheter tip were noted in one patient each. Conclusion: There is a need for a special attention for the diagnosis and management of intradialytic complications of hemodialysis because such complications could be managed successfully without the need of subsequent termination of dialysis procedure.