Hello, Chills are a complication of patients undergoing hemodialysis. The rate of infection among hemodialysis patients presenting with chills is not well established, and an empirical broad-spectrum antibiotic is usually the rule. Patient with no obvious of infection, with fistula or graft as access, presenting without fever have a low risk of bacteria in the blood and may be without prompt antibiotic treatment. All other patients should receive antibiotic immediately following chill episode. Anemia also may cause you to feel cold: Anemia is the result of kidney disease patients not producing as much hear in their bodies due to fewer red blood cells which carry oxygen through the body. Low iron can also the reason why you feel chilly. Talk to your doctor how you can control your anemia. Think about blood temperature while you do hemodialysis. Can be the air-conditioning too cold in the center. You should talk to your doctor and health care team about other physical reasons that may be causing you to feel cold. You should ask about the temperature of the dialysis, and medicines you are taking any other cause that could be making you feel cold. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Heang Chan Raksmey, General & Family Physician