Hemodialysis

Hemodialysis (haemodialysis)

-is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure.

-Hemodialysis can be an Inpatient or Outpatient therapy.

•  Inpatient is conducted in a dialysis outpatient facility, either a purpose built room in a hospital or a dedicated, stand alone clinic.Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians
•  Outpatient is done at home and can be self initiated and managed or done jointly with the assistance of a trained helper who is usually a family member.

Hemodialysis uses a machine filter called a dialyzer or artificial kidney to remove excess water and salt, to balance the other electrolytes in the body, and to remove waste products of metabolism. Blood is removed from the body and flows through a tubing into the machine, where it passes next to a filter membrane. A specialized chemical solution (dialysate) flows on the other side of the membrane. The dialysate is formulated to draw impurities from the blood through the filter membrane. Blood and dialysate never touch in the artificial kidney machine.

For this type of dialysis, access to the blood vessels needs to be surgically created so that large amounts of blood can flow into the machine and back to the body. Surgeons can build a fistula, a connection between a large artery and vein in the body, usually in the arm, that causes a large amount of blood flow into the vein. This makes the vein larger and its walls thicker so that it can tolerate repeated needle sticks to attach tubing from the body to the machine. Since it takes many weeks for a fistula to mature enough to be used, significant planning is required if hemodialysis is to be considered as an option.

If the kidney failure happens acutely and there is no time to build a fistula, special catheters may be inserted into the larger blood vessels of the arm, leg, or chest. These catheters may be left in place for up to three weeks. In some diseases, the need for dialysis will be temporary, but if the expectation is that dialysis will continue for a prolonged period of time, these catheters act as a bridge until a fistula can be planned, placed, and matured.

There are 3 types of hemodialysis:

Conventional hemodialysis

The patient is attached to a dialysis machine which pushes blood to circulate through the patient’s body and machine, while at the same time monitor temperature, blood pressure and time of the procedure. If the patient is using a fistula or graft, two huge-gate needles on the patients’ side will be planted: one brings blood containing waste products from the patients’ body to the dialyzer, while another needle carries clean blood back to the body. It is offered three times a week and 3 or 4 hours per session. Patients are required to follow their rigid schedule.

Daily hemodialysis

The procedure of daily hemodialysis is similar to the conventional hemodialysis except it is performed six days a week and about 2 hours per session.

Nocturnal hemodialysis

The procedure of nocturnal hemodialysis is similar to conventional hemodialysis except it is performed six nights a week and 6 to 10 hours per session while the patient sleeps.