The primary advantage of dialysis is the extension of life. People whose kidneys no longer work can die within weeks without dialysis or a kidney transplant.

There are a number of risks common with chronic kidney failure that can occur with either form of dialysis. These conditions occur because the kidneys no longer make hormones or balance the body’s electrolytes and other chemicals. Potential risks of dialysis include:

• Anemia. Insufficient red blood cells result from lack of erythropoietin (EPO), a hormone made by kidneys that stimulates creation of red blood cells. Dialysis patients often receive supplemental EPO because the kidneys no longer form it. Contributors to anemia also include inadequate consumption of vitamins or iron, and blood loss caused by procedures, tests and anticoagulant medications. Some research has found overuse of anemia drugs in dialysis patients. In 2007 the U.S. Food and Drug Administration tightened warning labels on these erythropoiesis-stimulating agents (ESAs) because of potential risks including heart attack and stroke. The agency recommends using the lowest dosage needed to avoid blood transfusions.
  
  
• Weakened bones. Bone disease caused by kidney failure (renal osteodystrophy) affects 90 percent of dialysis patients, according the U.S. National Institutes of Health (NIH). The condition has similarities to osteoporosis. Women and older individuals are at increased risk, and the condition is especially serious in children. Insufficient calcium in the blood (hypocalcemia) can cause the parathyroid glands to release a hormone drawing calcium from the bones and thus weakening them. Excess phosphorus (hyperphosphoremia) can also leach calcium from the bones. Treatments include low-phosphorus diet, medication and exercise.
  
  
• Itchiness (pruritus). Many people on dialysis experience itchy skin. Causes include excess phosphate, wastes that dialysis cannot remove from the blood and mineral imbalances caused by overactive parathyroid glands. Treatments include low-phosphorus diet or phosphate binders, EPO injections, exposure to ultraviolet light, skin creams and removal of the parathyroid glands.
  
  
• Abnormal heart rhythm (arrhythmia). Electrolyte imbalances, such as too much potassium in the blood (hyperkalemia), can affect the heart rate. Avoiding potassium-rich foods can help.
  
  
• Amyloidosis. The accumulation of protein in the organs and tissues. Amyloidosis of the joints and tendons has symptoms similar to those of arthritis: stiffness, pain and fluid in the joints. Dialysis-related amyloidosis (DRA) is common in people who have been on dialysis for more than five years.
  
  
• Sleep disorders. People on dialysis often experience insomnia, which is often caused by aching in the legs (due to mineral imbalances). Treatment includes moderate exercise well before bedtime, warm baths, massages, medications, and avoiding caffeine, alcohol and tobacco. Some people on dialysis suffer from sleep apnea, interrupted breathing while asleep. This might result from disrupted control of breathing caused by kidney failure. Treatments for apnea include change of sleep position, weight loss and use of a mask that brings air into the nose.
  
  
• High blood pressure (hypertension). Elevated blood pressure is common among patients with diabetes and is of particular concern to patients with diabetes and kidney disease.

• Peripheral neuropathy (nerve damage in the limbs, hands and feet). Also a major problem for diabetic patients, it can worsen if waste products accumulate in the bloodstream.