March 18, 2022
8 min. read

Which Medications to Take—And Which to Avoid—During Dialysis

Medly

Normally, your kidneys filter extra water and waste out of your blood to make urine. But nearly 750,000 people a year experience kidney failure in the United States, which occurs when your damaged kidneys are not able to filter blood the way they should. If you experience kidney disease, treatments include kidney transplant or dialysis.   

 

To help you get the most out of your dialysis treatment, you may need to take certain kidney medications and vitamins. And if you also have other health conditions like diabetes, high blood pressure, or high cholesterol, you may also be prescribed additional medications to treat these conditions. Below, we’ll cover the most common medications dialysis patients take—as well as a few that you should avoid. 

What is dialysis?

If you are diagnosed with chronic kidney disease, or CKD, dialysis can be a lifeline. Dialysis is an artificial means of removing water and toxins from the blood in the same way that the kidneys naturally do. This process isn’t a cure for the disease, but it does help take toxins out of your body, keeping your body functioning until you are able to access a transplant operation. 

What are the types of dialysis? 

There are two ways to get dialysis:

  • Hemodialysis
  • Peritoneal dialysis

 

In hemodialysis, a machine filters wastes, salts and fluid from your blood when your kidneys are no longer healthy enough to do this work adequately. During hemodialysis, your doctor will cut a specific part of your body, usually the arm, to gain access to an artery and vein. Patients undergoing hemodialysis typically go to the hospital three times a week for about three to five hours to have their blood cleaned using a dialysis machine. Waste and extra fluids pass from the blood and the filtered blood is returned to the body. During the procedure, you may experience minor problems such as nausea or abdominal cramps. 

 

The peritoneal dialysis process is slightly different from hemodialysis. With this technique, a catheter removes waste from your body through the stomach. This form of dialysis can be self-administered, or administered through a caregiver at home. While you can do this form of dialysis while at home, work, or traveling, peritoneal dialysis requires a certain amount of dexterity and ability to care for yourself at home—it isn’t an option for everyone with kidney failure. 

What should I know about taking medication while on dialysis? 

When you’re on dialysis, your body processes medications and vitamins differently than it normally otherwise would. This makes following the dialysis medication guidelines and taking all medications exactly as prescribed—on time and with or without food—of utmost importance. If you’re not clear on how to take your dialysis medications, ask your healthcare provider or pharmacist—they are there to help.

What medications might I take during dialysis? 

There are a few common medications or vitamins that your healthcare provider may recommend during dialysis. 

Renal vitamins

Water-soluble renal vitamins include vitamins Bl, B2, B6, and B12, folic acid, niacin, pantothenic acid, biotin, and vitamin C. Renal vitamins replace vitamins and nutrients that are lost during dialysis treatment, or not adequately received through daily diet. 

Vitamin D 

In those with chronic kidney disease, low vitamin D levels can be found, sometimes even severely low levels. This may occur because injured kidneys are less able to convert vitamin D into its active form. Taking Vitamin D, however, may be able to correct this vitamin deficiency. 

Iron 

In chronic kidney disease, kidneys don’t make enough of a hormone called erythropoietin (EPO), which your body needs to make red blood cells. Your body also needs iron to make red blood cells. When there is not enough EPO or iron, you make fewer red blood cells, and anemia develops. Supplementing with iron can help treat anemia due to blood loss or deficiencies of iron in diet.

Phosphate binder 

Phosphorus is a mineral that’s found naturally in many foods and also added to many processed foods. After eating these foods, this phosphorus will enter your blood, though most is typically removed by the kidneys. Damaged kidneys, however, fail to remove this phosphorus, which can lead to a high level of phosphorus in the blood.  A phosphate binder can be taken to reduce the absorption of phosphorus consumed in foods and drinks. 

Stool softener 

Constipation is common in patients with CKD. A stool softener may be recommended to help. 

Heparin

Heparin is a blood thinner that is regularly used during dialysis to prevent blood clots from forming as blood flows through dialysis tubing or the dialyzer during treatment.

Epogen, Aranesp or Mircera

Epogen, Aranesp or Mircera are medications that are used to help your body create more red blood cells and raise your hemoglobin level to help fight anemia and decrease the need for a red blood cell transfusion. 

Topical creams & antihistamines 

Because dialysis removes extra water from your body, this can cause itchiness and dry skin. Your healthcare provider may recommend topical creams or antihistamines to relieve these symptoms. 

Blood pressure medications 

Hypertension, or high blood pressure, is very common in patients on dialysis. These medications can help to control your blood pressure. 

Which medications should I avoid while on dialysis? 

When your kidneys aren’t working as they should, certain medications can build up in the blood and cause additional damage to your kidneys or other parts of your body. For this reason, your doctor may tell you to avoid or adjust some medication if you have chronic kidney disease. But be sure not to stop taking any medication without talking to your healthcare provider first.  

NSAIDs 

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are pain relievers and can also be found in many medications marketed for fevers, colds, coughs, and sleeping problems. However, those with kidney failure should avoid these drugs because they reduce blood flow to the kidneys. 

Proton pump inhibitors 

Proton pump inhibitors, or PPIs, are used to treat acid reflux and heartburn. While it has not been proven, there is some evidence that PPIs increase the risk for kidney disease. Talk to your doctor if you are taking PPIs or other acid reflux medications. 

Cholesterol medications 

Cholesterol medications, known as statins, are usually prescribed to help lower cholesterol levels in the blood. Talk to your doctor to see if you need to adjust these medications to protect your kidneys during dialysis. 

Antibiotics 

Antibiotics, antiviral, and antifungal medications may harm your kidneys, so your doctor will need to be aware of your level of kidney function before prescribing these treatments.

Diabetes medications 

Diabetes is the leading cause of kidney disease. If you have diabetes, it is important to control your blood sugar, though you may need to adjust the dosage of your medication. 

Antacids 

Over-the-counter antacids can disrupt the body’s electrolyte balance if you have chronic kidney disease. Check with your healthcare provider before taking any sort of OTC antacid. 

Herbal supplements and vitamins

Many herbal supplements contain minerals like potassium or phosphorus. These minerals can be damaging for those with chronic kidney disease, so most need to be avoided if possible. 

 

If you’re on dialysis, understanding each of your medications is an essential aspect of your treatment. Manage your prescriptions according to dialysis medication guidelines, and check with your doctor before taking any new medications. If you’re having trouble with your medications, you can always enlist your pharmacists, who can help ensure there are no conflicts with any existing or new medications. 

 

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