Feverish after dialysis with burning sensation and bodyache

Hello Doctor,

My wife aged 49 weight 41kg is undergoing Dialysis in Hospital for last 9-10 months using catheter on her right chest.

She is experiencing feverish but no fever after each Dialysis session (twice a week dialysis), fesverish burning sensation in the whole body is accompanied by bodyache and weakness.
For the weakness part , Nephrologist has added 250 amino acid solution in last hour of dialysis along with multivitamin injection in Normal saline solution in last 15-20min duration of dialysis.

She is a diabetic for last 20 years but her diabetes is under control for last 3 years.

Since Oct 23 she is feeling this unknown reason feverish + whole body severe pain only after dialysis lasting for 12-18 hrs.

Her Nephrologist tried to ruled out any sepsis by conducting CRP test ,regular blood tests and 2D echo

Results were.not indicating any infection of major problem to the heart ,although diastolic dysfunction (mild) were.reported. mah be thats the reason for her diastolic BP to be in the range 60 to 75 mostly.

She is hypertensive patient after.the start of dialysis in March 2023 and given 4 types of BP medicines - arkamin 0.1 mg (2 tablets each 3 times a day) , Nicardia xl 60mg 2 times a day , cardivas 12.5mg (2 times a day ) , Dytor 100mg( 2 times a day - this is stopped recently after she is diagnosed with sudden hearing loss in left head to 95% level) , minipress xl 5mg (SOS once a day) .

Hee feverish problem is making her more weak and unstable .

Also when she started dialysis in Mar 23 her weight was 51kg and now it’s 41kg. She is more of.skeleton now

From last 2 dialysis along with burning and feverish feelings accompanied by bodyache (primarily legs and back ) she also has fever ranging from 99.9 F to 100.8 F which had subsided after paracetamol 650mg .

Recently we had gone to her breast surgeon for 2 lumps and when we did mammogram ,there is a 3rd one small in size but of category birad 4A was found .doctor suggested for biopsy to rule out any trouble. So far it’s not done.

For last 2 reports of blood tests ,i have noticed alkaline phosphatase is higher than normal range . I. Not sure of these results of alkaline phosphatase is linked to her feverish and burning sensation now.