Module 16—Long-term Effects of Dialysis

Dialysis and nerves

Neuropathy in people on dialysis is quite common—from 60% to 100% may have it. Why? In one study, more active nerves were found right after an HD treatment. Toxins that build up in the blood may poison the nerves.

We don't know which toxins are to blame. One clue points to potassium. Studies have found that high potassium levels slow nerve function. Another middle molecule may also be at fault: TNF-alpha, or TNFα. It has been found in higher levels in people on PD who have neuropathy than in those who don't.

You may or may not have any symptoms of nerve problems. Here is a list you can show to your doctor. Check all that apply:

Tingling
I have "pins and needles" in my hands and/or feet.

Pain
I have stabbing or shooting pains in my hands and/or feet.
My hands or feet feel like they are burning.
My feet are very sensitive to touch (e.g., the covers on at night).
My feet hurt at night.
My hands and/or feet get very hot or cold.

Numbness or weakness
My feet are numb.
I don't feel any pain in my feet, even when I have a sore.
I can't feel my feet when I walk.
The muscles in my feet and legs are weak.
The muscles in my hands or feet have shrunk or wasted away.
I have foot drop (have a hard time lifting my toes when I walk).
I am unsteady when I walk or stand.
I can't feel heat or cold in my hands and/or feet.

Other
It seems like the muscles and bones in my feet have changed.
It feels like I am walking on marbles.
I have open sores on my feet and legs that heal slowly.
(For men only) I have trouble getting an erection.

If you have any symptoms, be sure to tell a member of your health care team about them. Some can be caused by other health problems, so you'll need to be checked by a doctor to be sure. Knowing about neuropathy is the first step to doing something about it. Read on, and we'll talk about preventions and treatments next.

Page 24 of 30 | Further reading

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