What causes knots on arms while undergoing kidney dialysis?
Patient: I have been on Dialysis since June, 2011. (female, 55 years old, 5'11" 185 lbs) Last test showed kidneys functioning at 4%. I have noticed most of the long time patients have huge, round protrusions (knots) about the size of a ping-pong ball  on their arms. I find that very disturbing. I developed a swollen, hard, area two weeks ago that is still tender , after an infiltration.  What causes the "knots" I have seen and is there any way to prevent them. Doctor: Hello and welcome to HCM.As an Urologist and transplant surgeon,i can understand your anxiety.Your kidney function at 4%,is like a non-functioning kidney.Dialysis or a kidney transplant are the only options available.A transplant is the best option. All people on weekly dialysis,will have a fistula on their forearms,for access. That should be the knots you see.Once the A-V fistula has matured,the veins get swollen up and prominent.If they're hard or tender,you must show it your nephrologist.Thrombophlebitis is a possibility.You'll need treatment for it.If you've any doubts,send all reports to me,as a direct question.Dr.Matthew J. Mangat.