Hemodialysis
What is Hemodialysis?
Haemodialysis is a treatment that uses a machine and dialyzer to purify blood, removing waste and excess fluids. The process typically occurs in hospitals or dialysis centres, usually three times a week for about four hours per session.
How Haemodialysis Works:
- Blood Pumping: Blood is pumped from the body to the dialyzer via tubing. Heparin or saline prevents clotting.
- Dialyzer Function: The dialyzer (artificial kidney) filters blood through a semi-permeable membrane, using a special solution called dialysate.
- Returning Blood: Cleaned blood is then returned to the body.
Types of Vascular Access:
- Central Venous Catheter: Used for short-term access, inserted into a large vein in the neck, chest, or leg. Ideal for immediate use but less preferred for long-term.
- AV Fistula: A long-term access option created by connecting an artery to a vein in the arm. It requires time to mature but is more durable and less prone to complications.
- AV Graft: For patients who can’t use an AV fistula, a synthetic tube connects an artery and vein. It is less durable and more prone to complications than an AV fistula.
Caring for AV Fistula:
- Prevent Infection: Keep the site clean and use sterile techniques.
- Protect the Fistula: Avoid injections, blood draws, or tight clothing on the access arm. Prevent injury and heavy lifting.
- Ensure Proper Functioning: Regularly check for the “thrill” (vibration) and report any issues to your healthcare provider.
- Exercise: Regular exercise can improve the function and durability of the fistula.
Haemodialysis Machine and Dialyzer:
- Machine Functions: Prepares dialysate, adjusts and monitors its composition, and ensures patient safety with various alarms.
- Dialyzer Structure: A plastic cylinder with hollow fibres filters blood. Waste and excess fluid are removed through the dialysate.
Dialysate: A special fluid that helps remove waste and excess fluids from the blood. It is prepared from purified water and a dialysate concentrate containing electrolytes and minerals.
Treatment Locations and Experience:
- Locations: Typically performed in hospitals or dialysis centres, though some stable patients may do it at home.
- Experience: Generally not painful; patients can rest, read, or watch TV during treatment.
Common Problems:
- Low blood pressure, nausea, cramps, weakness, and headache can occur. Proper monitoring and management of diet and fluid intake can help.
Advantages:
- Performed by trained staff, less stressful than peritoneal dialysis, more efficient, and provides a social environment.
Disadvantages:
- Requires frequent visits to a centre, potential discomfort from needles, and strict dietary restrictions.
Do’s and Don’ts:
- Do’s: Adhere to dietary restrictions, monitor weight gain, and maintain proper nutrition.
- Don’ts: Avoid missing treatments, over-the-counter multivitamins, and non-compliance with dietary advice.
When to Contact a Doctor:
- If experiencing bleeding, loss of AV fistula function, unexpected weight gain, severe symptoms, or signs of infection.
Haemodialysis is vital for managing chronic kidney disease, and proper care and adherence to guidelines are essential for effective treatment.
