Hemodialysis immediate complications 1. Dialysis imbalance syndrome: It mainly occurs in patients with high creatinine, urea nitrogen and other toxins. Especially in patients with irregular hemodialysis and first dialysis. The main symptoms of dialysis imbalance syndrome include nausea, vomiting, headache, fatigue, irritability, etc. Its incidence can be 10-20%. In severe cases, there may be convulsions and tremors. Once the above symptoms appear, please tell the medical staff immediately to get timely treatment and discontinue dialysis if necessary. 2. First time use syndrome: It is mainly caused by the application of new dialyzers and tubing. It mostly occurs a few minutes to an hour after the start of dialysis. It is characterized by dyspnea, generalized fever, and sudden cardiac arrest. In mild cases, the symptoms are itching, hives, cough, lacrimation, runny nose, muscle cramps, diarrhea, etc. 3, hypotension: the incidence is 20%-40%. There are many reasons for the occurrence of hypotension, the main ones are: ① Decrease in effective circulating blood volume and decrease in blood volume. After the start of hemodialysis there is 160-270ml of blood in the extracorporeal circulation line, which reduces the side pressure of circulating blood volume on the vascular wall; the ultrafiltration rate is too large and dehydration is too fast. Although the water in the patient’s body increases, most of it exists in the tissue interstitial space, especially in malnourished low-protein patients, and the rate of returning to the blood vessels is much smaller than the rate of dehydration. ② Autonomic dysfunction and maladaptation to the decrease in blood volume at the start of opening extracorporeal circulation. Most of this hypotension occurs at the beginning of dialysis. The drop in blood pressure in the middle and late stages of dialysis is mostly due to rapid ultrafiltration or maladaptation to dialysis fluid. (iii) Peripheral vascular sclerosis with reduced elasticity. Typical manifestations of hypotension include nausea, vomiting, sweating, pallor, dyspnea and drop in blood pressure. 4. Hypertension in dialysis: It mainly occurs in the middle and late stages of dialysis, the cause of which is unclear, and it is relatively stubborn and difficult to deal with. At present, it is believed that it is related to factors such as increased renin-angiotensin activity in blood caused by dialysis and imbalance syndrome due to clearance of small molecule uremic substances. 5, headache in dialysis: relatively rare, its incidence is 5%, common causes are hypertension, neurological headache. 6, arrhythmia: the causes of arrhythmia include coronary heart disease, heart failure, pericarditis, severe anemia, electrolyte and acid-base balance disorders, hypoxemia, hypotension and drugs. The incidence of arrhythmias is 50%. Arrhythmias are complex and have different clinical and electrocardiographic manifestations, and should be treated appropriately according to the type of arrhythmia. 7, muscle spasm in dialysis: Although the cause of muscle spasm is not well understood, it may be related to tissue hypoxia, low sodium and reduced circulating blood volume in dialysis. If discomfort occurs during dialysis, the patient should promptly report it to the doctor or nurse and do not be nervous, as the health care provider will give prompt treatment.