Hemodialysis: What You Need to Know

Hemodialysis, often referred to as dialysis or blood washing, is a vital procedure for people whose kidneys are no longer functioning properly. When kidneys fail, they can't effectively filter waste products and excess fluid from the blood. Hemodialysis steps in to perform this critical function, helping patients maintain a healthy balance.

Why is Hemodialysis Necessary?

Healthy kidneys act as filters, removing waste and excess fluid that the body produces through daily life. If the kidneys are damaged by diseases, the cleaning function can be disrupted such as in kidney failure. This means the waste builds up and poisons the body.

Hemodialysis becomes essential when the kidneys can no longer adequately perform these functions. Conditions that can lead to kidney failure requiring dialysis include:

• Diabetes: High blood sugar levels can damage the kidneys over time.
• High Blood Pressure: Uncontrolled hypertension can put strain on the kidneys, leading to failure.
• Glomerulonephritis: Inflammation of the kidney's filtering units.
• Polycystic Kidney Disease: An inherited disorder causing cysts to grow in the kidneys.
• Severe Kidney Infections: Repeated infections can cause kidney damage.

How Hemodialysis Works

Hemodialysis involves using a machine called a dialyzer (artificial kidney) to filter the blood. The process generally involves these steps:

• Access Creation: A vascular access needs to be created to allow efficient blood flow. The doctor will do surgery to create an access in one of your blood vessels. This is usually done in your arm or neck. There are several types of access that your doctor might recommend. The most common types are an arteriovenous (AV) fistula or grafts.
• Connecting to the Dialysis Machine: During dialysis, your blood flows through a tube to the dialyzer.
• Blood Filtration: Inside the dialyzer, the blood passes through a special membrane that filters out waste products, excess fluid, and toxins.
• Returning Cleaned Blood: The filtered blood is then returned to your body through another tube.
• Monitoring: Throughout the procedure, vital signs like blood pressure and heart rate are closely monitored.

Where is Hemodialysis Performed?

Hemodialysis is typically performed in a dialysis center or hospital. With proper training, some individuals can perform hemodialysis at home. However, this option requires a suitable home environment and a dedicated caregiver.

How Often is Hemodialysis needed?

The frequency and duration of hemodialysis sessions will vary depending on individual needs and the severity of kidney failure. Typically, patients undergo dialysis three times a week, with each session lasting about 3-4 hours. Your doctor will determine the optimal schedule for you.

What to Expect During a Hemodialysis Session

During the dialysis, you will sit or recline in a chair. The dialysis technician will monitor you, and you will also be able to do what you enjoy. Some patients read, watch TV, or sleep during the process.

Potential Risks and Side Effects

Like any medical procedure, hemodialysis carries some potential risks and side effects. These can include:

• Low Blood Pressure (Hypotension): A common side effect due to fluid removal.
• Muscle Cramps: Can occur during or after dialysis.
• Itching: A result of waste buildup between dialysis sessions.
• Nausea and Vomiting: Can occur as a result of blood pressure changes or other factors.
• Infection: Possible at the access site.
• Blood Clots: Can form in the access or the dialysis machine.
• Bleeding: At the access site.
• Arrhythmias (Irregular Heartbeat): Electrolyte imbalances can cause heart rhythm problems.

It's important to report any unusual symptoms or discomfort to the dialysis staff immediately.

Living with Hemodialysis

Hemodialysis is a life-sustaining treatment, and it requires commitment and lifestyle adjustments. However, many people on dialysis live full and active lives. Important aspects of living with hemodialysis include:

• Dietary Management: Following a kidney-friendly diet is crucial. This often involves limiting sodium, potassium, phosphorus, and fluids.
• Fluid Restriction: Controlling fluid intake is essential to prevent fluid overload.
• Medication Management: Taking prescribed medications as directed is vital.
• Monitoring Health: Regular check-ups and blood tests are necessary to monitor kidney function and overall health.
• Emotional Support: Dialysis can be emotionally challenging. Seeking support from family, friends, support groups, or mental health professionals can be beneficial.

When to See a Doctor

If you experience any of the following, contact your doctor:

• Signs of infection at the access site (redness, swelling, pain, pus).
• Fever or chills.
• Chest pain or difficulty breathing.
• Severe or persistent nausea and vomiting.
• Unexplained weight gain.
• Changes in mental status.

In conclusion, hemodialysis is a life-saving treatment for people with kidney failure. While it requires commitment and lifestyle adjustments, it allows patients to maintain their health and live fulfilling lives. If you have concerns about your kidney health, talk to your doctor.