In most instances, missing or postponing a single hemodialysis treatment does not result in a catastrophe.If patients are having effective dialysis treatments, adhering to their diet and fluid restrictions, and taking their medications properly, dialysis can be rescheduled for later the same day or even the next day safely.Patients who are not receiving good dialysis or keeping their diet may develop puffiness around the face, fluid in the legs, and shortness of breath.This is due to fluid overload. Typically, these symptoms occur on the longer interval between hemodialysis treatments on those days.Dialysis is a renal replacement therapy,the kidneys work 24 hours a day, 7 days a week. Dialysis does not replace all of our renal function.Hemodialysis 3 times a week at best replaces 12% to 15% of normal renal function.If we miss one hemodialysis treatment, we miss one-third of our weekly renal replacement therapy. This can result in immediate problems such as too much fluid in our body or a high potassium level in our blood.Weakness, fatigue, and loss of appetite can occur.If dialysis treatments are missed frequently, the toxins and poisons that build up in our blood can damage our peripheral nervous system.Symptoms include numbness and tingling of the hands and feet, pain, and weakness.The poisons can cause inflammation in the lining of our heart, or pericarditis.Fluid overload from missing many treatments can put a strain on the heart, leading to an enlarged heart that is not able to effectively pump blood.Poisons can affect the lining of our stomach and cause gastritis, which in turn can cause decreased appetite, abdominal pain, nausea, and vomiting.In severe forms, bleeding can occur, which may require admission to a hospital for emergency treatment.
