Chronic Hemodialysis
What is it?
Chronic hemodialysis is a procedure used to treat
kidney failure. A patient’s blood is removed from the body
through a vein and circulated through a machine that
filters the waste products and excess fluids from the
blood. The “cleaned” blood is then returned to the body.
Chronic means this procedure is performed on a regular
basis.
Who needs this procedure?
People whose kidneys no longer function as they should
require hemodialysis. Loss of kidney function can be
caused by disease, a traumatic injury, drugs or poisons,
or an obstruction of the urinary tract.
How do I prepare for this procedure?
Once the decision is made to begin hemodialysis, your
doctor or a dialysis specialist will explain the procedure
to you. He or she will identify the area where the blood
will be removed from a vein and returned, called the
access site. Your blood pressure, temperature, and weight
will be checked right before each hemodialysis treatment.
Your “before” weight will be compared with your weight
after treatment to make sure you are not retaining too
much fluid. You may be given an injection of a drug that
prevents blood clotting, called an anticoagulant, so your
blood flows freely through the hemodialysis machine.
Because the procedure takes a few hours, you may want to
bring a companion, some reading material, or an activity
that can be done while sitting. Although the possibility
of contracting an infectious disease such as hepatitis
during hemodialysis treatment is slight, it is recommended
that hemodialysis patients receive the hepatitis B
vaccination before beginning treatment.
How is this procedure performed?
Hemodialysis sessions take place in a hospital’s
dialysis unit or an outpatient dialysis center. You can
sit up and remain fully alert while receiving hemodialysis. Two needles are usually inserted, one to
remove the blood from the vein, and the other to return
the blood. The blood flows through plastic tubing to a
filter called a dialyzer. A dialyzer works somewhat like
an oil or fuel filter in a car. It consists of many small
fibers that collect the waste products and extra fluids
that your kidneys are unable to filter from the blood. The
dialyzer is surrounded by a fluid called dialysate.
Dialysate is a chemical solution that takes the wastes and
extra fluids trapped by the dialyzer and carries them away
from the blood. The dialysate also contains electrolytes
and other chemicals that your body needs to maintain in a
careful balance in order to function properly. These are
added to the purified blood, which is then returned to
your body through the second needle. During this process,
the dialysis machine monitors the flow of blood, as well
as your blood pressure. A hemodialysis session usually
takes anywhere from two to five hours. Patients requiring
chronic hemodialysis usually need three sessions per week.
Some patients on chronic hemodialysis choose to learn to
perform this procedure with a machine at home. Your
healthcare provider can discuss with you whether this is
an option.
What can I expect after the procedure?
Throughout your hemodialysis treatments, your blood
will be tested regularly for levels of blood urea nitrogen
(BUN), which tells your doctors how well the hemodialysis
process is filtering waste products from your blood. Your
doctor will explain how to keep your access site clean to
prevent infection, and how to detect signs of infection.
He or she will also provide you with guidelines for your
diet and prescribe medications to treat your condition. It
is especially important to monitor your intake of fluids,
sodium, and potassium, following your doctor’s
recommendations. Your doctor will also recommend vitamin
and mineral supplements to replace those lost during your
treatment. Possible side effects of hemodialysis treatment
include headache, nausea and vomiting, cramps, anemia (low
red blood cell count), itching (pruritis), trouble
sleeping, and a sudden drop in blood pressure (hypotension). Most side effects can be relieved by making
adjustments to your treatment, so you should report any
side effects to your doctor immediately. Because
hemodialysis requires a sizeable time commitment and has a
great impact on lifestyle, relationships, and activities,
some patients find they begin to feel depressed. It is
important to seek the support of family and professional
counseling to relieve these feelings and maintain your
quality of life.
Self-care tips
If you are receiving hemodialysis treatments, follow
your doctor’s diet, fluid intake, and medication
recommendations. Your doctor can suggest a registered
dietician who can help you find the right diet to meet
your needs.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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