Hemodialysis is a medical procedure of cleansing the blood of toxins, extra salt, and fluids through a dialysis machine. It helps maintain proper chemical balance such as potassium, sodium, and chloride and keeps blood pressure under control.
How does Hemodialysis work?
During hemodialysis, two needles will be inserted 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 dialyzer, which is made of tiny capillaries.
Blood is continuously pumped through the dialyzer, where waste product and excess water is removed. The blood becomes purified when the waste products diffuse from the blood across the membrane of these tiny capillaries. The blood which is purified by the above process is then returned to the patient’s body through larger tubes.
Hemodialysis is generally performed 3 times a week, with each session lasting about 4 hours, depending on the body size and medical condition.
How does the dialyzer clean the patient’s blood?
The dialyzer has two parts, one for the blood and one for a washing fluid called dialysate. A thin membrane separates these two parts. Blood cells, protein and other important things remain in patient’s blood because they are too big to pass through the membrane. Smaller waste products which are present in the blood, such as urea, creatinine, potassium and extra fluid pass through the membrane and are washed away.
Things to take Care during Hemodialysis
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 they are on hemodialysis treatment. It is important that the catheter is kept dry, even when taking a bath.
The patients will also need to take care of their fistula or graft. Patients should not wear anything tight around the fistula/graft arm like 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.
Patients 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 is any problem with their fistula/graft.
Lifestyle Issues related to Hemodialysis
It usually takes a few months for patients to adjust to hemodialysis. It is normal for patients to have concerns over their personal life. With rehabilitation, counseling and strong family support, patients can overcome the struggles they face.
With good hemodialysis treatment, patients can still live a normal life. Depending on the individual’s condition apart from kidney failure, many people are fit enough to work.
If the patients are still in school, they can and should continue with their education, and can even take part in sports and other recreational activities.
Hemodialysis sessions can be taken to fit in their daily routine. Patients can take holidays as long as arrangements can be made for hemodialysis treatments abroad.
Exercising is good for the body as well as for the mind. It is beneficial for kidney patients to engage in sports and exercises as long as precautions are taken. Check with the doctor for the exercises and sports that can be done.
What to expect after Hemodialysis?
About one time in a month, the patient will have blood tests to make sure he is getting the right amount of hemodialysis. These tests are performed to find out how well hemodialysis is working.
The weight before and after each session will be recorded, as will the length of time it takes to complete the dialysis session. If the patient is performing hemodialysis at home, he will need to have records of his weight before and after each session and the length of each session.
What are the different tests which have to be performed before Hemodialysis?
Some of the tests which have to be performed before Hemodialysis are:
1.    Blood Tests
2.    Kt/V Test