RELATED STORIES • Dialysis: Managing your medications • Hemodialysis and peritoneal dialysis: What's the difference? • Hemodialysis for kidney failure: Is it right for you? • Slide show: A step-by-step look at hemodialysis • Hemodialysis: Compare conventional and daily treatment schedules • Dialysis medications: What they do, what to watch for • Peritoneal dialysis: A flexible treatment option for kidney failure • Slide show: A step-by-step look at peritoneal dialysis • Video: Hemodialysis

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Dialysis is a serious responsibility. If you need hemodialysis or peritoneal dialysis to treat kidney failure, you'll work closely with your health care team to manage your health. Understand the possible complications — and what you can do to prevent them.

Complications may be related to dialysis or the underlying kidney disease itself.

• Anemia. If you have anemia, you don't have enough red blood cells in your bloodstream. This may leave you feeling weak and tired. Lack of the hormone erythropoietin, which is made by healthy kidneys to stimulate production of red blood cells, often causes anemia. In other cases, low levels of iron or vitamins in your blood — caused by diet restrictions, poor absorption of iron, or removal of iron and vitamins by dialysis — cause anemia. Blood loss from dialysis or routine blood sampling can have the same effect.
• Bone diseases. If your damaged kidneys are no longer able to use vitamin D to absorb calcium, your bones may weaken. If your parathyroid glands produce too much parathyroid hormone — a common complication of kidney failure — calcium may be stripped from your bones.
• High blood pressure (hypertension). High blood pressure is a leading cause of kidney failure. If you eat too much salt or drink too much fluid while being treated for kidney failure, your high blood pressure may only get worse — which takes a toll on your remaining kidney function. Left untreated, high blood pressure can lead to a heart attack or stroke.
• Fluid overload. If you drink more fluids than recommended, you may retain enough fluid to cause life-threatening complications, such as heart failure or fluid accumulation and swelling in the lungs (pulmonary edema).
• Inflammation of the membrane surrounding the heart (pericarditis). Insufficient dialysis can lead to inflammation of the membrane surrounding the heart, which can interfere with your heart's ability to pump blood to the rest of your body.
• High potassium levels (hyperkalemia). The kidneys normally excrete excess potassium from the body. If your kidneys are failing and you eat more potassium than recommended, your potassium level may become higher than normal. In extreme cases, too much potassium can cause your heart to stop.
• Nerve damage. Chronic kidney failure can damage your nerves. Damage to your peripheral nerves — also known as peripheral neuropathy — may cause pain, numbness or tingling in your legs, feet or hands.
• Infection. Depending on the type of dialysis you receive, potentially dangerous infections at the venous access point or peritoneal catheter are possible.
• Other complications. Other difficulties associated with dialysis include sleep disorders, anxiety and depression.

You're the most important member of your health care team — especially when it comes to preventing or correcting problems that can lead to long-term or life-threatening complications.

• Be diligent about dialysis. Whether you receive dialysis at home or in a dialysis center, do so according to your doctor's directions. Skipping dialysis or not doing dialysis on schedule can lead to complications.
• Take steps to prevent infection. If you're receiving hemodialysis, keep the access point clean and protect the area from injury. If you're receiving peritoneal dialysis, wash your hands before you handle the catheter, and clean the catheter with antiseptic every day.
• Follow your meal plan. Eating the right foods can improve your dialysis and your overall health. Be especially careful to monitor your intake of fluids, protein, sodium, potassium and phosphorous.
• Take your medications as prescribed. While you're receiving dialysis, you'll likely need to take various medications. Report any side effects to your doctor.
• Report complications. If you suspect complications or develop unusual signs or symptoms, tell your doctor.

Sometimes a kidney transplant ends the need for dialysis. In the meantime, dialysis is a lifesaving treatment. But sometimes the burden of dialysis becomes too great — especially if complications develop or your health deteriorates. Share your wishes about long-term dialysis and end-of-life care with your family and your health care team.