Managing Dizziness and Nausea During Dialysis: Key Considerations

Dizziness, vomiting?

Hello, my mother has been experiencing dizziness and even vomiting for about two months after or during dialysis since the second day of the Lunar New Year.
She has taken anti-nausea medication and has undergone a thorough examination in the neurology department (which was normal), but her condition is still not very stable.
What else should we be paying attention to? Thank you!

Meiguo, 40~49 year old female. Ask Date: 2004/03/26

Dr. Lü Yuansan reply Internal Medicine

Common causes of dizziness or vomiting during dialysis are a drop in blood pressure, which may be due to the patient's pre-existing cardiovascular issues or excessive weight gain during the dialysis session.
It is advisable to consult a physician to adjust antihypertensive medications and dry weight, and to avoid excessive fluid intake.
Another possibility is dialysis disequilibrium syndrome; please consult the physician at the dialysis center for further guidance.

Reply Date: 2004/03/26

More Info

Managing dizziness and nausea during dialysis is a critical concern for patients undergoing this treatment, especially for those who experience these symptoms consistently. Your mother’s experience of dizziness and nausea during or after dialysis can be attributed to several factors, and understanding these can help in managing her symptoms more effectively.

Potential Causes of Dizziness and Nausea During Dialysis
1. Fluid Shifts: During dialysis, fluid is removed from the body, which can lead to rapid changes in blood volume and pressure. This can cause dizziness, especially if the fluid is removed too quickly. Patients may also experience hypotension (low blood pressure), which can lead to lightheadedness and nausea.

2. Electrolyte Imbalance: Dialysis can alter the levels of electrolytes in the body, such as sodium, potassium, and calcium. An imbalance can lead to symptoms like dizziness and nausea. Monitoring and adjusting electrolyte levels is crucial during treatment.

3. Dialysis Technique: The type of dialysis (hemodialysis vs. peritoneal dialysis) and the specific technique used can impact how well the patient tolerates the procedure. For example, the dialysate temperature, blood flow rates, and ultrafiltration rates can all influence patient comfort.

4. Underlying Health Conditions: Conditions such as anemia, which is common in patients with kidney disease, can contribute to feelings of dizziness and fatigue. Additionally, other comorbidities, such as heart disease or neurological issues, may exacerbate these symptoms.

5. Medication Side Effects: If your mother is taking medications for her kidney condition or other health issues, some of these may have side effects that include dizziness and nausea. It’s important to review her medication list with her healthcare provider.

Management Strategies
1. Fluid Management: It may be beneficial to discuss with her dialysis team about adjusting the fluid removal rate during dialysis. Slower fluid removal can help minimize drops in blood pressure and reduce dizziness.

2. Monitoring Blood Pressure: Regularly monitoring blood pressure during dialysis can help identify hypotension. If her blood pressure drops significantly, the dialysis team can take immediate action, such as adjusting the treatment or administering fluids.

3. Electrolyte Monitoring: Ensure that her electrolyte levels are regularly checked. If imbalances are detected, her treatment plan may need to be adjusted accordingly.

4. Dietary Adjustments: A dietitian specializing in renal nutrition can provide guidance on dietary changes that may help manage symptoms. This may include adjusting fluid intake and ensuring adequate nutrition to support her overall health.

5. Medication Review: Have her healthcare provider review her current medications to identify any that may be contributing to her symptoms. Adjustments or alternatives may be necessary.

6. Symptom Management: If nausea persists, anti-nausea medications may be prescribed. Additionally, discussing the use of medications for dizziness with her healthcare provider can be beneficial.

7. Regular Follow-ups: Continuous communication with her healthcare team is essential. If her symptoms do not improve or worsen, further investigations may be warranted to rule out other underlying issues.

Conclusion
It’s essential to approach the management of dizziness and nausea during dialysis holistically, considering all potential contributing factors. Regular follow-ups with her nephrologist and dialysis team will ensure that her treatment is tailored to her needs and that any complications are addressed promptly. If her symptoms continue to be problematic, seeking a second opinion or consulting a specialist in nephrology or a related field may provide additional insights and management options.

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