Dialysis patients face many treatment issues that may aggravate the patient status. They include haemodynamic stress due to intra- and inter-dialysis changes in cardiac filling, fluctuations in blood pressure, acid-base imbalance and alterations in serum electrolyte levels. Several of these issues can be minimized with proper dialysis therapies.
ESRD patients combine traditional cardiovascular risk factors common to all patient populations (e.g. hypertension, diabetes, dyslipidaemia, smoking) and additional risk factors caused by long-term dialysis treatment (e.g. anaemia, chronic inflammation, oxidative stress).
They may experience fatal bleeding complications. If the bleeding risk becomes high enough the anticoagulant should be reduced or avoided.
ESRD patients diagnosed with diabetes approach dialysis with complications prevalently correlated to an inadequate metabolic control, such as diabetic neuropathy, arterial hypertension, dyslipidaemia and cardiovascular diseases. Dialysis worsens these already present complications both in the acute and chronic phases.