Disadvantages *Restricts independence, as people undergoing this procedure cannot travel around because of supplies' availability *Requires more supplies such as high water quality and electricity *Requires reliable technology like dialysis machines *The procedure is complicated and requires that care givers have more knowledge *Requires time to set up and clean dialysis machines, and expense with machines and associated staff Complications Fluid shifts<unk>  often involves fluid removal (through ultrafiltration), because most patients with renal failure pass little or no urine. Side effects caused by removing too much fluid and/or removing fluid too rapidly include low blood pressure, fatigue, chest pains, leg-cramps, nausea and headaches. These symptoms can occur during the treatment and can persist post treatment; they are sometimes collectively referred to as the dialysis hangover or dialysis washout. The severity of these symptoms is usually proportionate to the amount and speed of fluid removal. However, the impact of a given amount or rate of fluid removal can vary greatly from person to person and day to day. These side effects can be avoided and/or their severity lessened by limiting fluid intake between treatments or increasing the dose of dialysis e.g. dialyzing more often or longer per treatment than the standard three times a week, 3–4 hours per treatment schedule. Access-related Since<unk>  requires access to the circulatory system, patients undergoing<unk>  may expose their circulatory system to microbes, which can lead to bacteremia, an infection affecting the heart valves (endocarditis) or an infection affecting the bones (osteomyelitis). The risk of infection varies depending on the type of access used (see below). Bleeding may also occur, again the risk varies depending on the type of access used. Infections can be minimized by strictly adhering to infection control best practices. Venous needle dislodgement Venous needle dislodgement (VND) is a fatal complication of<unk>  where the patient suffers rapid blood loss due to a faltering attachment of the needle to the venous access point. Anticoagulation-related Unfractioned heparin (UHF) is the most commonly used anticoagulant in<unk> , as it is generally well tolerated and can be quickly reversed with protamine sulfate. Low-molecular weight heparin (LMWH) is however, becoming increasingly popular and is now the norm in western Europe. Compared to UHF, LMWH has the advantage of an easier mode of administration and reduced bleeding but the effect cannot be easily reversed. Heparin can infrequently cause a low platelet count due to a reaction called heparin-induced thrombocytopenia (HIT). In such patients, alternative anticoagulants may be used. The risk of HIT is lower with LMWH compared to UHF. Even though HIT causes a low platelet count it can paradoxically predispose thrombosis. In patients at high risk of bleeding, dialysis can be done without anticoagulation. First-use syndrome First-use syndrome is a rare but severe anaphylactic reaction to the artificial kidney. Its symptoms include sneezing, wheezing, shortness of breath, back pain, chest pain, or sudden death. It can be caused by residual sterilant in the artificial kidney or the material of the membrane itself. In recent years, the incidence of first-use syndrome has decreased, due to an increased use of gamma irradiation, steam sterilization, or electron-beam radiation instead of chemical sterilants, and the development of new semipermeable membranes of higher biocompatibility. New methods of processing previously acceptable components of dialysis must always be considered. For example, in 2008, a series of first-use type of reactions, including deaths, occurred due to heparin contaminated during the manufacturing process with oversulfated chondroitin sulfate. Cardiovascular Longterm complications of<unk>  include<unk> -associated amyloidosis, neuropathy and various forms of heart disease. Increasing the frequency and length of treatments has been shown to improve fluid overload and enlargement of the heart that is commonly seen in such patients. Vitamin deficiency Folate deficiency can occur in some patients having<unk> . Electrolyte imbalances Although a dyalisate fluid, which is a solution containing diluted electrolytes, is employed for the filtration of blood,<unk>  can cause an electrolyte imbalance. These imbalances can derive from abnormal concentrations of potassium (hypokalemia, hyperkalemia), and sodium (hyponatremia, hypernatremia). These electrolyte imbalances are associated with increased cardiovascular mortality.
Hemodialysis
Iridodialysis
Peritoneal dialysis
Dialysis
Hemofiltration
Home hemodialysis
Hemoperfusion
Intravenous sodium bicarbonate