Haemodialysis

What is ?Haemodialysis

Haemodialysis is a treatment for those patients whose kidneys cannot function any more. It is a way of cleansing the blood of toxins, extra salts and fluids through a dialysis machine called "artificial kidney". It helps maintain proper chemical balance such as potassium, sodium and chloride and keeps blood pressure under control.

How does it work?

During dialysis, two needles will be placed into the vascular access, one to remove the blood and the other to return cleansed blood to the body. The patient is connected (via tubing) to the dialysis machine through a vein in the arm, the blood is pumped from the body to a special filter called the dialyser, which is made of tiny capillaries.
Blood is continuously pumped through the dialyser, where waste products and excess water are removed. The blood becomes purified when the waste products diffuse from the blood across the membrane of these tiny capillaries. This purified blood is then returned to the patient's body through larger tubes.
Haemodialysis is performed 3 times a week, with each session lasting about 3 to 5 hours, depending on the body size and medical condition. At the NKF, patients can choose Mondays, Wednesdays and Fridays or Tuesdays, Thursdays and Saturdays. They can also choose the morning, afternoon or evening session.

Things to take care...

Before and during dialysis, the patients need to clean the skin covering the access before inserting the needles to avoid infection. If any signs of infection are noticed, inform the nurse immediately. The patients need to make sure that their blood is flowing and not clotting while on treatment. It is important that the catheter be kept dry, even when taking a bath.
The patients will also need to take care of their fistula or graft. They should not wear anything tight around the fistula/graft arm i.e. watches, bracelets, tight clothing, or carry heavy bags looped over the fistula/graft. Besides checking that the fistula/graft is working by feeling for the buzzing sensation every morning and night, the patients should not allow non-dialysis staff to take blood or blood pressure on their fistula/graft arm. They need to observe for signs of infection, such as redness, oozing of blood or pus, swelling and heat, and contact the nurse immediately if there are any problems with their fistula/graft.

Possible Complications

During dialysis, especially on the early stages, the patient may experience the following problems:

Signs	Causes	Remedies
Hypertension, light-headedness, nausea or vomiting	Sudden drop in blood pressure due to the rapid removal of fluids	Return fluids back to the body
Muscle cramps	As above
Fatigue	Fluid exchange	Resting after treatment

The patient can avoid many of the associated side effects like muscle cramps and hypotension (sudden drop in blood pressure) by following a proper advice and taking their medication as directed. Always report any side effects to the doctor.