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Common incidents during dialysis
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Haematoma: the blood vessels are relatively fragile and a haematoma
at the puncture site is not uncommon. It will disappear in a few
weeks at the most without effects other than the aesthetic aspect.
- Needle insertion failure: the fistula can be difficult to pierce
when too fine, twisted or deep. It is necessary to try another site.
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Coagulation in the circuit: coagulation can take place if the anticoagulant
dose is inadequate or the blood flow is too low. The circuit must
be replaced. The blood loss in this case is around 250 ml.
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Cramp: cramp is relatively frequent during dialysis, especially
toward the end of the session. Alert the care personnel who will
attend to the problem.
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Low blood pressure: blood pressure is lowered due to the weight
loss during dialysis. Ideally, the session should finish with the
correct dry weight and normal blood pressure. If the dry weight
has been underestimated or you are compromised by additional illness,
blood pressure may fall during the session. This will be felt as
faintness, disturbed vision, and then loss of consciousness. Alert
the staff as early as possible to allow the nurse to intervene quickly.
A rapid perfusion will restore blood pressure in a few seconds.
These symptoms occur in about 5% of dialyses.
Severe complications
associated with dialysis
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Acute oedema of the lungs: excessive weight increase or overestimation
of the dry weight may provoke acute oedema of the lungs due to passage
of plasma into the alveoli causing progressive asphyxia. Lying down
becomes impossible. There is a sensation of gasping for breath.
Weight reduction by dialysis is necessary as quickly as possible.
Contact the
Centre de Dialyse on 02 38 51 22 22 or the Clinique de l'Archette
on 02 38 51 61 71, who will warn the duty nephrologist. They will
explain the necessary steps to be taken.
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Hyperkalaemias: a potassium restricted diet must be strictly followed
when prescribed. An excess of potassium causes hyperkalaemia. This
begins with a general feeling of weakness with numbness of the feet,
hands and mouth. The pulse rate falls below 50/min. The heart may
stop beating. Take two units of Kayexalate and contact the Centre
using the numbers shown above who will act quickly
Other
major complications
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Anaemia: this is frequent and generally well controlled by EPO injection.
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Accelerated cardiovascular ageing: cardiac follow up is necessary.
It is strongly recommended to avoid the use of tobacco.
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Hyperparathyroid: responsible for calcium and phosphorus problems.
Itching may occur when phosphorus levels are too high. Bones become
brittle and the blood vessels calcify.
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