Does anyone get hives/rash after treatment?

As you all know I have started the nxsatge machine. However, after my treatment I seem to break out in a itchy/hive rash. This also occurred when I was in the unit on the machine. It goes away in a few hours…but I was wondering if this happens to anyone else, and if so what can you do?



Hi Vanessa

I don’t think it’s normal for this happen. You should mention that to your nurse or nephrologist, and sometimes you have to be a little persistent about it. The first year I was on dialysis, I put up not with actual hives, but itching during treatment and extending into a couple of hours after. It turned out I was allergic to something in the dialyzer (the chemical used to sterilize them after manufacture). I kept being told that if I didn’t have actual hives, it was nothing to worry about. But let me tell you, it was darned uncomfortable! I was eventually switched to a dialyzer which is sterilized by electron beam and I never looked back - never had the problem again.

Now this is just one example of what can happen. There are other things that can cause reactions like this. Sometimes the plastic tubing needs to be rinsed before you get on, sometimes it could be the heparin, etc. Whatever the cause, it’s certainly not something you should put up with. I’ve known a few people for whom the cause could never be identified. They ended up being given Benadryl each treatment. That might not be a good idea at home though, because it causes sleepiness and you would not be able to properly monitor your treatment.

Good luck.


Sounds more like your phosphorous levels increase while you dialyze…if your eating while dialyzing try not to eat while dialyzing, only drink a little if needed. If your taking TUMS you can try some while dialyzing which might help but first be sure your Calcium and phosphorous levels are okay…

It could be a reaction to the dialyzer. You might try priming it with two bags of saline (assuming you do that with the Nxstage). You also might try taking a benedryl during your treatment and see if that stops the itching. I also agree with Gus that a post draw to check your chemistries would be a good idea.

Have you called NxStage to ask them if other patients have reported this problem?

As others have said, you could have an allergy to any of a number of things related to dialysis or medications you’re taking or even a food that you’re eating. I found information about blood testing for allergies at

If your dialysis nurse and nephrologist aren’t sure what is causing it, you might want to schedule an appointment with a dermatologist at a time that you’ll probably have the rash. Tell the dermatologist you’re on daily home hemo and ask if he/she needs to see the supplies you use for dialysis and know what chemicals and medicines you take and use with your dialysis (like heparin, saline, etc.).

When I use to dialyze in center this itching problem among more than 1/2 the patients had to do with elevating phosphorous during treatment. I went through that ordeal as well, even met one patient that wouldn’t stop itching till he started bleeding from itching too much.

It’s just weird, phosphorous and calcium don’t behave during treatment…it just goes out of balance for most of us patients…

The way I solved mine is by taking TUMS when that reaction starts…that’s when I was in-center…

However, now that am on NxStage that problem disappeared completely…

High phosphorus can definitely cause itching and I knew patients that scratched themselves raw due to it. Your advice about reviewing lab results for calcium and phosphorus was right on.

I remember the doctor I worked telling dialysis patients how important it was to take the right amount of phosphate binders and to take them at the right time during the meal. Perhaps you should be sure you’re taking the right pill(s) in the right dosage at the right time to keep your phosphorus under control. If your phosphorus labs are OK, then it would be time to start looking at other causes.

A couple of other causes I can think of off hand would be allergies and/or stress. I knew patients who went to dermatologists and got special lotions or creams that seemed to help some with itching. I believe there was some kind of light treatment too. If stress could be the culprit try some relaxation exercises or listening to calming music while you’re doing dialysis or afterwards when you normally get the rash to see if that helps.

If your blood level of phosphorus is high, ask your dietitian about high phosphorus foods. It’s possible you’re eating something that has high phosphorus, but you don’t know it. One of my patients had high phosphorus and didn’t know that the biscuits she ate every day were at least part of the cause. Phosphorus is really had to control on 3 times a week dialysis, but is easier on daily, and even better controlled on nocturnal dialysis. I hope you get relief soon.

Do you break out all over or in a specific location?

What you are experiencing is not likely related to phosphorous. The hives are a rather clear symptom of an anaphylactic type reaction which is usually caused by some material of construction or sterilization in the extracorporeal circuit. Given the relatively huge amount of plastic in the NxStage circuit, you are being exposed to large amounts of plasticizers and a lot of areas where sterilants can be sequestered and released only when your blood flows through it.

The best defense against this is to use large volumes of saline to prime and if that doesn’t work consider the Aksys system which uses no platicizers or chemical sterilants.

I wanted to let you all know that yesteday I did not get the reaction of hives…I did not prime with more saline…and my phos. levels are normal. It seems like sometimes I get the hives and other times I don’t.

I do admitt that the plastic smell of the nxstage mateials always makes me feel sick…

Thanks for all you help.


Did you observe what you did differently on the days you didn’t get hives/itch? compared to days you do??

Did you eat while on dialysis? Did you eat right before dialysis? Did you drink something? Did you takes pill or something?