Roughly one Filipino develops chronic kidney disease every hour, according to NKTI. For those whose kidneys eventually fail, dialysis is a lifesaving treatment that cleans the blood, but it is not effortless. Most patients feel side effects in the first few months, so this guide explains what is normal, what can be managed, and what needs immediate attention.
Why Dialysis Causes Side Effects
Healthy kidneys filter waste and excess fluid from your blood around the clock. When chronic kidney disease reaches its final stage, they can no longer keep up, and toxins build to dangerous levels.
That buildup has a name. Uremia is the state where nitrogen waste and other toxins accumulate in the blood, causing nausea, fatigue, and confusion. Dialysis reverses it in scheduled sessions rather than continuously. Because the treatment does in a few hours what your kidneys once did nonstop, your body has to adjust to rapid shifts in fluid and chemistry, and those shifts are the source of most side effects.
The Two Main Types of Dialysis
Your side effects depend heavily on your type of dialysis, so a quick recap helps. If you are still weighing whether you need to start at all, see our guide to when you really need dialysis.
- Hemodialysis (HD): Your blood is pumped out, filtered through a machine, and returned to your body. Sessions usually run three times a week, three to four hours each, in a center.
- Peritoneal dialysis (PD): A cleansing solution called dialysate is placed into your abdomen through a catheter, and the lining of your abdomen acts as the filter. PD is done at home, daily, and is a common form of home dialysis in the Philippines.
Each method removes waste differently, so the two carry different side effect profiles.
Common Hemodialysis Side Effects
Low Blood Pressure During the Session
The most common side effect. Removing fluid too fast can drop your blood pressure, causing dizziness, nausea, cramps, or fainting. Solutions include slowing fluid removal, adjusting your dry weight target, and eating lightly before the session.
Muscle Cramps
Cramping in the calves or feet is common, usually toward the end of a session, caused by rapid fluid shifts and changes in electrolytes like sodium and potassium. Tell your dialysis nurse when it happens so they can adjust the protocol.
Headache
Headaches often appear during or right after sessions. Common causes are blood pressure drops, caffeine withdrawal, rapid fluid removal, and dialysis disequilibrium syndrome early in treatment. Persistent or severe headaches need medical evaluation.
Fatigue After Sessions
Many patients feel drained for hours after dialysis, sometimes for the rest of the day. Plan to rest afterward. If fatigue is severely disrupting work, ask about schedule changes such as evening sessions.
Itchy Skin
Itching is often caused by phosphorus buildup or dry skin. Use mild moisturizers, follow your phosphate binder schedule, and avoid hot showers. Persistent itching is worth raising with your nephrologist.
Restless Legs at Night
Many dialysis patients feel restless legs at night. Causes range from iron deficiency to magnesium levels and nerve changes. Mention it to your team, because it is treatable.
Access Area Problems
Your vascular access is your lifeline for hemodialysis, so watch it closely for any signs of infection. For a fistula or graft in the arm, look for swelling, redness, or loss of the “thrill,” the buzzing sensation you feel over a working access. For a central line in the chest or neck, fever, redness around the line, or chills mean you should go to the hospital.
Anemia
Reduced kidney function means less erythropoietin, the hormone that tells bone marrow to make red blood cells. Fewer red cells means less oxygen in circulation, which deepens fatigue. Most dialysis patients need erythropoietin injections and iron supplements to correct it.
Common Peritoneal Dialysis Side Effects
Abdominal Discomfort
A full feeling is normal when fresh solution is in the abdomen, and it usually settles. Severe abdominal pain is not normal and may signal infection.
Fluid Accumulation Despite Dialysis
Sometimes your body holds onto too much fluid even with regular exchanges. Causes include too few exchanges, a dialysate concentration that is too weak, and high salt intake. Discuss it with your nephrologist; it is often fixed with a prescription adjustment.
Peritonitis
An infection of the abdominal lining, peritonitis is the main serious risk of PD. Symptoms are cloudy dialysis fluid, abdominal pain, and fever, and it requires urgent treatment. Strict hygiene during exchanges lowers the risk significantly.
Catheter Exit-Site Infection
Redness, pus, or pain where the catheter exits your skin points to an exit-site infection. Careful daily care catches these early, before they progress to peritonitis.
Weight Gain
PD fluid contains glucose, which your body absorbs. Many PD patients gain weight over time, especially with higher-glucose exchanges, so nutrition and light exercise become more important.
Hernia
The fluid in your abdomen puts steady pressure on the abdominal wall, making hernias more common in PD patients. Surgical repair is sometimes needed.
Dialysis Side Effects That Are Not Normal
Most side effects are manageable, but a few are emergencies. Get medical attention immediately for any of these:
- Severe chest pain
- Difficulty breathing that does not ease when you sit up
- Sudden weakness on one side of the body or facial drooping
- Confusion or sudden changes in behavior
- High fever over 38.5°C
- Severe access bleeding that does not stop with pressure
- Repeated vomiting that keeps you from holding down fluids
- Cloudy peritoneal dialysis fluid
- Severe abdominal pain that does not settle
These can signal cardiovascular events, infection, or dangerous electrolyte problems. Do not wait to see if they pass.
How to Manage Dialysis Side Effects
- Stick to your schedule: Skipping sessions lets toxins and fluid build up, so the next session has to do double duty, which usually means worse side effects.
- Control the amount of fluid you drink: Most HD patients have a daily fluid limit. Drink to thirst rather than habit, and avoid salty foods that make you crave fluid.
- Watch your potassium: High potassium from foods like bananas and citrus can affect your heart rhythm between sessions. Our kidney-friendly Filipino diet guide and a renal dietitian can help you plan meals.
- Take phosphate binders with meals: Not before, not after. They only work when food is in the stomach.
- Stay active with light exercise: Walking, gentle yoga, and swimming improve stamina, mood, circulation, and dialysis tolerance. Check with your team first.
- Prioritize nutrition and protein: Dialysis removes protein, so your needs go up once treatment starts. Ask your team before starting any supplement.
- Treat anemia: Untreated anemia worsens fatigue dramatically, so make sure your team monitors your iron and erythropoietin needs.
- Address mental health: Depression and anxiety are common on dialysis, and treatment helps, so talk to your team or a mental health professional. In a crisis, the DOH National Center for Mental Health runs a free 24/7 hotline at 1553 (landline) or 0917-899-8727.
Managing the Social and Work Impact
Dialysis takes time, and that reality shapes daily life. HD requires three weekday sessions, while PD requires several daily exchanges or overnight cycling at home. A few strategies protect your quality of life:
- Schedule HD around work hours, since many centers offer early morning or evening slots
- Consider PD, which fits regular workdays because exchanges happen at home
- Talk openly with your employer where possible
- Connect with patient support groups for shared coping tips
Many Filipinos work full or part time while on dialysis. The treatment reshapes your routine, but it does not have to end your working life.
When to Push for Changes
If side effects keep disrupting your life, raise these options with your healthcare provider:
- Ask about switching modality, from HD to PD or the reverse
- Request a different schedule, such as longer or more frequent sessions
- Explore home dialysis, which is less common in the Philippines but available
- Raise transplant evaluation if it has not been discussed
You are not stuck with your first plan. Dialysis care is highly adjustable, and small changes often make a big difference.
Frequently Asked Questions
Why do I feel so tired after every dialysis session?
Post-dialysis fatigue is common and real. It comes from rapid fluid removal, blood pressure shifts, anemia, and your body adjusting after toxins are cleared. It often improves over months, so tell your team if it stays severe.
What are the most serious dialysis side effects?
The emergencies are severe chest pain, trouble breathing, sudden one-sided weakness, high fever, uncontrolled access bleeding, and cloudy PD fluid. These can point to heart, infection, or electrolyte problems and need immediate care.
Can I exercise while on dialysis?
Yes. Light exercise improves stamina, circulation, and mood. Avoid heavy strain on the arm with your fistula, and check with your dialysis team before starting a new program.
Is fluid accumulation always serious in peritoneal dialysis?
Not always, but never ignore it. It can mean inadequate dialysis, a weak dialysis solution, or too much salt and fluid intake. Your team can adjust the prescription.
Can I travel while on dialysis?
Yes, with planning. Hemodialysis patients can arrange guest sessions at a center in their destination, and many large dialysis centers in the Philippines accept them, though arrangements vary. Book several weeks ahead and hand-carry your recent treatment records and prescription.
Will I always need dialysis?
For chronic kidney failure, yes, until a kidney transplant becomes possible. For acute kidney injury, dialysis can be temporary while the kidneys recover.
Conclusion
Dialysis side effects are a normal part of adjusting to treatment, and most of them can be managed with the right schedule, diet, and support. Knowing which signs are routine and which need urgent care puts you in control of your own health.
You do not have to manage kidney disease alone. NowServing helps you find and consult experienced nephrologists across the Philippines, so you can get answers about your side effects and your care plan whenever you need them. Find a kidney doctor or nephrologist on NowServing and book your consultation today.
