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Written By: Steve L. Belcher, RN, MSN, MS, DN-CM

When a kidney patient begins outpatient hemodialysis for the first time, an informed consent form for hemodialysis has to be signed to begin the hemodialysis treatment. The informed consent for hemodialysis explains the hemodialysis procedure, risks associated with hemodialysis, and side effects related to hemodialysis. Patients are either given this form to read or have read to them. At the end of this form patients or their legally authorized representative, the physician, and a witness are expected to sign the consent form acknowledging that the patient will immediately notify their physician if any adverse reactions or problems they may have with regard to the hemodialysis treatment. In addition, patients are also acknowledging that they authorize repeated hemodialysis treatments unless they specifically revoke the consent and that they fully understand the consent form and its contents. Patients are given a chance to have their questions answered in words that they can understand. However, many patients are not feeling their best and may experience anxiety on their first day of outpatient hemodialysis treatment. What many patients don’t understand are many of the risks below associated with hemodialysis. While such risks are not common, one or more can occur and be potentially life threatening:

  • Bacterial and/or viral (e.g., Hepatitis B or C) contamination of the patients blood which may cause infection, or bacterial infection of the blood called sepsis.
  • Bleeding due to blood clotting problems or disconnection of blood tubing
  • “Destruction” or the breakdown of red blood cells, known as hemolysis
  • Internal bleeding or bleeding from the access site
  • Infections of your access site (Catheter or Fistula infections)
  • Introduction of air into your bloodstream
  • Shock or cardiac arrest
  • Allergic and toxic reactions to drugs, solutions, artificial kidneys or other equipment used during the hemodialysis treatment
  • Clotting of your access or infiltration of your access

In addition, there are also other side effects that may be associated with hemodialysis related to fluid and chemical changes during or after the hemodialysis treatment. Some of these side effects are osteoporosis, electrolyte imbalance, headache, nausea, dizziness, fainting, irregular heartbeats, a decrease in blood pressure, muscle cramping, and mild confusion. This is just a small important part of the informed consent form and if you have any questions about your informed consent talk with your physician or dialysis clinic management.

About the author

Steven Belcher, RN, MSN, MS, is a dedicated kidney advocate who began his journey 20 years ago as a dialysis nurse. This job inspired him to help as many people with kidney disease as he could. Not only did he spend two decades caring for a patient’s physical and emotional needs in a clinical setting, but he also educated the public on the risk factors of kidney disease. Some of his many philanthropic successes include being a keynote speaker at the National Association of Nephrology Technicians/ Technologists (NANT), presenting at community spaces, and launching radio shows.

He now focuses his time entirely on his organization Urban Kidney Alliance, which educates the public about kidney disease. His goal? To lower rates of Chronic Kidney Disease in urban communities in Baltimore, Maryland, across the country, and globally through education and collaboration.

Steve has also written the book “HOW TO SURVIVE OUTPATIENT HEMODIALYSIS: A GUIDE FOR PATIENTS WITH KIDNEY FAILURE.” You can read the book review here.

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