Knowing which symptoms need urgent attention — and which don’t — is one of the most valuable things a caregiver or family member can learn. Here’s a practical guide to recognizing genuine dialysis emergencies.

Dialysis equipment during emergency home treatment

Signs That Need Immediate Attention

Contact your care team or emergency services right away if you notice sudden severe shortness of breath, chest pain, confusion or sudden difficulty staying alert, or fainting. These can indicate serious complications like fluid overload affecting the lungs or dangerous electrolyte imbalances that need urgent treatment.

Signs That Need Prompt But Not Emergency Attention

Contact your care team the same day (rather than waiting for a scheduled check-in) if you notice unusual swelling in the legs or around the eyes, a sudden change in typical fluid weight gain between sessions, or symptoms that feel different from the patient’s usual pattern even if not severe.

Access Site Emergencies

For patients with an AV fistula, seek immediate medical attention for sudden bleeding that doesn’t stop with gentle pressure, signs of infection (redness, warmth, swelling, or fever), or loss of the normal “thrill” or vibration you can typically feel over the fistula. For catheter patients, watch for similar infection signs and any sudden dislodgement.

What to Do While Waiting for Help

If bleeding occurs at an access site, apply gentle, steady pressure with a clean cloth and keep the limb elevated if possible — but don’t apply a tourniquet or excessive pressure that cuts off circulation entirely. Stay with the patient, keep them calm, and have their medical information (current medications, dialysis schedule, and treating physician) ready to share with responders.

When It’s Not an Emergency

Mild fatigue after a session, minor and expected soreness at the access site, or typical hunger and thirst within normal fluid restriction guidelines are usually not emergencies — though it’s always reasonable to call your care team with questions if something feels uncertain.

Building a Family Emergency Plan

Related Reading

This guidance is based on our team’s 14+ years of hands-on dialysis experience, but always follow your specific care team’s instructions for your loved one’s situation.

Need emergency dialysis support? Call us directly at 03009532248, available 24/7.

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