Answer: To respond to this question the physician polled a series of patients who were doing well with hemodialysis. Four had AV grafts, four had AV fistulae and two had catheters. None of the patients with catheters could feel any sensation. One patient with a fistula and one with a graft could feel blood coursing through their access. The remaining patients could not.

Patients on peritoneal dialysis uncommonly feel a pulling sensation toward the end of the cycle at the time fluid is draining. Otherwise, they have no sensation of peritoneal dialysate fluid transfer.

For the most part, neither hemodialysis nor peritoneal dialysis are uncomfortable procedures. The most common complaints heard regarding hemodialysis relate to painful cannulation (placement of the dialysis needles) or the discomfort of having to stay in a chair for four hours. Sometimes patients have cramps during the procedure, usually related to rapid fluid shifts. Other pain and discomfort during dialysis frequently requires medical attention.

Peritoneal dialysis patients who have pain at any time during the procedure should contact their healthcare provider, as it may represent a symptom of early peritonitis or catheter malfunction.

Answer provided by Stephen Fadem, MD, who serves as a member of AAKP’s Medical Advisory Board and the AAKP Board of Directors. Dr. Fadem is a practicing nephrologist in Houston, Texas. Dr. Fadem was assisted by Catherine Brown, PA-C, for this study. Ms. Brown is the clinical healthcare coordinator for Kidney Associates.

The Dear Doctor column provides readers with an opportunity to submit renal related health questions to healthcare professionals who specialize in the area of concern. The answers are not to be construed as a diagnosis and therefore, altercations in current healthcare should not occur until the patient's physician is consulted.

This article originally appeared in aakpRENALIFE, September 2003 Volume 19 Number 2. 

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