Haemodialysis risks and side effects
Your child’s healthcare team will show you how to care for your child’s exit site & catheter to reduce any risks and watch out for signs so any complications can be treated quickly.
Risks from creating access
- Inserting a central venous line (or line): common risks include bleeding, bruising and formation of a blood clots around the end of the catheter.
- Creating a fistula: risks include bleeding, or failure to develop, which may mean that a repeat operation or a graft needs to be made instead.
Other risks
- ‘Steal syndrome’ in a fistula – where there is less blood flow to the hand, which may cause a feeling of tingling, numbness or cold in the hand, and may require surgery.
- Infections due to germs entering the body – this is more likely in a line than in a fistula. Keeping the exit site clean will reduce the risk. Most infections can be treated with antibiotic medicines, which kill germs. If they are more serious, surgery and/or a new line may be needed.
- Blood clots (thrombosis) – if this happens in a line, fistula or graft, it may stop working.
- Narrowing of blood vessels (stenosis) – this usually happens slowly and your child’s dialysis team can look for early warning signs.
Side-effects of haemodialysis
Most side-effects are caused by changes in the amount of water and chemicals in your child’s blood. Your child should follow the treatment plan set out by your doctor, including diet, fluids and medicines to avoid these side-effects. Side-effects your child may get are:
- feeling tired during or after the dialysis session
- muscle cramps
- low blood pressure (hypotension), which may be sudden – children may feel weak, dizzy or light-headed, or sick.
Peritoneal dialysis risks and side effects
Your child’s healthcare team will train you how to manage peritoneal dialysis and care for your child at home. They will also give you information about what to look for, so any complications can be treated quickly.
Poor drainage
One common complication is when fluid (liquid) does not properly drain out of the peritoneal cavity. This may happen for different reasons.
- The catheter may become kinked or blocked, such as when a child lies on it (for example, rolling over at night) – this can usually be easily corrected.
- Blood or fibrin (a protein) from the body can get stuck in or around the catheter. A medicine called heparin can be added to the dialysate (dialysis fluid) to help prevent this.
- Occasionally, the poor drainage keeps happening. This may be because the catheter gets displaced, or omentum (a fold of tissue in the abdomen) gets wrapped around the catheter. The catheter will usually need to be replaced if this occurs. Some children who have previously had surgery in the abdomen may have adhesions. If this happens, peritoneal dialysis may need to be stopped and haemodialysis considered as an alternative.
Other risks
- Infections due to germs entering the body, especially peritonitis, which is an infection of the peritoneum. Keeping the exit site clean will reduce the risk. Most infections can be treated with antibiotic medicines, which kill the germs. If the infection is more serious, the catheter will need to be removed, and a new catheter placed after the infection is gone.
- Hernias happen when an internal part of the body pushes through the wall around it and a lump in the tummy or groin can be seen.