My wife has hemodialysis twice a week. She is also hyper-sensitive to all types of medication. Her nephrologist has bent over backwards to find the answer to her symptoms but he is frustrated as is my wife. Immediately after dialysis, she begins to experience restless leg, tremors/shaking, muscle cramps, confusion, hallucinations, change in mental status. These symptoms last approx. 36 hours and then she is fine - that is, until her next dialysis treatment. She was on PD but she experienced similar symptoms during the training. Apparently, the PD catheter was put in wrong and she developed severe pain, adhesions and peritonitis. The PD was removed and a fistula was implanted. Is it possible for my wife to be allergic to the dialysate that is used or allergic to any of the contaminants used in the maintenance of the dialysis machine. We’re grasping at straws and we don’t know which way to go. Inasmuch as her symptoms reflect a neurological base, she has an appointment with a neurologist later this week.
First, I want to say that I’m a social worker, not a doctor. I hope her doctor is able to determine what is causing her symptoms.
Here’s a blog called Potential Allergic Contributors to Dialysis Symptoms by John Agar, an internationally recognized nephrologist from Australia.
Here’s an article that reports on possible causes of hypersensitivity reaction in one patient and suggests in the conclusion things to check.
Most people do hemodialysis 3 or more times a week. You say your wife is doing dialysis twice a week. How much urine does she produce? Has she been asked to do a 24-hour collection to determine the amount and to test for how well her kidneys are removing toxins? When determining if she’s getting enough dialysis, knowing the toxin removal in her urine would be important to know. What is her weight gain between her two treatments? How much fluid is she or her nurse(s) trying to take off per treatment? Removing too much fluid too fast can stun the organs including the heart and brain and cause multiple uncomfortable and serious symptoms. Check out this ultrafiltration calculator to see if the amount of fluid she’s trying to remove per treatment is in the green, yellow or red. It is recommended not to remove more than 13 ml/kg/hour. Removing 10 or less ml/kg/hour is even better.
Here’s an article entitled “Hearts in the Crossfire: Standard Hemodialysis Stuns Organs–But There Is Hope!”
Here’s an article by a patient entitled “The Elusive Dry Weight: A Dialyzor’s Lessons Learned.”
You might want to discuss these things with her doctor.