What is the most common complication during dialysis due to a rapid decrease in circulating blood volume?

Hypotension is the most common complication during dialysis caused by a rapid decrease in circulating blood volume. During hemodialysis, the process involves the removal of excess fluid from the blood, which can significantly lower blood volume. This sudden reduction can lead to a decrease in blood pressure, resulting in hypotension.

Patients often experience this drop in blood pressure because the dialyzer removes both excess fluid and certain electrolytes, leading to changes in blood volume status and hemodynamics. Symptoms of hypotension during treatment may include dizziness, lightheadedness, or fainting.

While slight confusion from electrolyte changes can occur, it is generally less immediate and pronounced compared to the effects of hypotension. Dehydration is also a concern but is typically addressed during dialysis by carefully managing fluid removal. Bleeding may occur at the site of access but is not directly related to the rapid decrease in circulating blood volume as hypotension is. Therefore, hypotension stands out as the primary complication linked to the quick reduction of circulating blood volume during the dialysis process.