Patients on haemodialysis could develop chills with or without fever. An isolated chill is a rare but not an uncommon complication of haemodialysis. It does not have a definite aetiology though often the reduction of the temperature of the dialysis fluid (dialysate) in the machine (undertaken to prevent lowering of the blood pressure during dialysis) could reduce the body temperature by 1 degree Celsius, which is well tolerated. However, it may induce chilling during the course of the dialysis treatment session. Chills when accompanied with a fever are indicative of an underlying bacterial infection in the blood or presence of foreign protein particles in the dialysate inducing a febrile reaction. In addition to ruling out any evidence of infection, it may be worthwhile to have the temperature of the dialysate adjusted.