Hemodialysis also called Dialysis or Renal Replacement Therapy, is a medical procedure for removing wastes and excess water from the body and is used primarily as an artificial replacement for lost kidney functions. The kidneys perform the work of removing waste products, regulating blood pressure and red blood cell production. When they fail, the waste products and fluids build- up in the blood, which can be life threatening.
Sometimes, dialysis is done for a short period, when the kidney fails from an acute (temporary) disturbance. In chronic kidney disease (Stage 5) also called end stage renal disease, where kidney damage is usually irreversible, dialysis will continue life- long, unless a renal transplant is done.
When is dialysis needed?
Dialysis is needed when more than 90 % of the kidneys fail to perform their functions. It takes many months or even years after the diagnosis of kidney disease for the patient to need dialysis. In early stages, the kidney disease is treated by medical or surgical management depending on the cause
When does one start dialysis?
This depends on the kidney functions, which is decided by a number of factors like general health, nutritional status, blood and urine tests, symptoms, deterioration of quality of life, etc. One will be advised to start dialysis before other organs get damaged or life threatening problems surface. Some patients may not have any symptoms but their kidneys may be severely damaged. Dialysis can become an emergency, when the patient is bleeding or is beginning to develop multi-organ failure.
What are the types of dialysis?
There are two types of dialysis
- Haemodialysis is what is commonly done in India
- Peritoneal dialysis
What hemodialysis entails
A special access through a larger vein has to be created for blood to be removed from the body, passed through the dialysis machine and returned to the body at a rate that is faster than can be done through a normal venous access as is done for giving intra-vascular fluids.
This step is done well before the start of a dialysis as the vascular access requires time to heal before it can be used to connect to the dialysis machine
Blood tests: Patients who undergo hemodialysis will be monitored with blood tests to ensure that duration and type of dialysis treatment are optimal. Correct dialysis treatment improves health, prevents complications and prolongs survival. Blood tests are done at least once a month and adjustments to the dialysis prescription may be made based upon the results.
Body weight monitoring: As kidneys that are failing and cannot remove enough fluid from the body, dialysis must perform this task. Accumulation of fluid between hemodialysis treatments can lead to complications. Most patients will be weighed before and after dialysis and will be asked to monitor their weight on a daily basis at home. If your weight increases more than usual between treatments contact your healthcare provider.
Caring for the vascular access — is important to prevent complications. Complications can occur even if one is careful, but are much less common if a few precautions are taken:
- Wash the access with soap and warm water each day and always before dialysis.
- Do not scratch the area or try to remove scabs.
- Check the area daily for signs of infection, including warmth and redness.
- Take care to avoid injuring the arm where the access is located;
- Do not wear tight clothes, carry heavy items or sleep on the arm.
- Do not allow anyone to take blood or measure blood pressure on this arm.
The patient's blood is pumped through the blood compartment of a dialyzer, exposing it to dialysis solution and water and wastes move between these two solutions. The cleansed blood is then returned via the circuit back to the body.
How long does each sitting of hemodialysis last?
The duration of each sitting varies for different patients. Usually it lasts 3-4 hours and is done 2-3 times a week (totally 12 hours a week)
Side effects of hemodialysis- Most patients tolerate hemodialysis well. Fall in blood pressure is the most common complication and can be accompanied by light headedness, muscle cramps, breathlessness, abdominal cramps, nausea or vomiting
To have a safe hemodialysis treatment, do consult our doctors at Columbia Asia Hospital India.