What monitoring parameters should be regularly assessed in patients undergoing dialysis?

Monitoring parameters for patients undergoing dialysis should include regular assessment of clinical fluid status, laboratory values, and fluid balance. This involves daily reassessments of fluid status through clinical examination including pulse, blood pressure, capillary refill, jugular venous pressure, and presence of oedema or postural hypotension. Fluid balance charts and weight measurements (at least twice weekly) are essential to monitor trends in fluid status. Laboratory investigations should include regular monitoring of urea, creatinine, and electrolytes to assess kidney function and electrolyte balance. Additionally, symptoms commonly experienced by dialysis patients such as breathlessness, fatigue, itching, swelling, muscle cramps, and neurological or psychological symptoms should be regularly reviewed and managed. Dietary assessments by a specialist renal dietitian, including monitoring of weight history, fluid intake, and key electrolytes like sodium, potassium, and phosphate, are also important to guide fluid and nutritional management during dialysis.

These monitoring parameters help detect complications such as fluid overload, electrolyte imbalances, and symptom burden, enabling timely intervention and adjustment of dialysis treatment.

References: ¹,²