Hemodialysis - A Treatment For Kidney Failure

Here is a way to live longer when you are diagnosed with kidney failure. If you have only ten to fifteen percent of kidney function left, you need kidney dialysis to keep your body alive. One of the kidney dialysis is hemodialysis. 

Let’s talk about hemodialysis, the procedure involved and preparation needed for it.

In hemodialysis, your blood goes through tubes from the body into the dialysis machine. The blood gets filtered through a filter called a dialyzer, and the cleaned blood travels back into your body from the machine through tubes. With the help of a partner, you can also do home hemodialysis. 

Compared to peritoneal dialysis, hemodialysis requires less time and surgical interventions and the risk of developing infections is also low.

Hemodialysis Access: To Allow Blood Travel To The Dialysis Machine

A minor surgery usually at your arm will be done before beginning hemodialysis to provide vascular access. Vascular access or hemodialysis access is a place where needles will be inserted to carry blood in and out of the body to the dialysis machine. 

During dialysis, your blood has to flow from and return back to the body at a higher rate, which will be favoured by vascular access. This makes the blood vessels stronger so that the needles can be used repeatedly.

Types Of Vascular Access:

• AV fistula: It is the safest access. It is done by joining an artery and vein (blood vessels) in your arm. Usually, physicians perform an AV fistula in your non-dominant arm. You are less likely to develop infections and blood clots from this access. It will be done two to three months before you start dialysis.
• AV graft: In this, a plastic tube is used to join an artery and vein in your arm. It will be done two to three weeks before you start dialysis. You are more likely to develop infections and blood clots from this. If you have any problems that prevent having AV fistula, you will have AV graft.
• Catheter: A soft plastic tube is placed in a large vein, most commonly in your neck. If your kidney disease progresses quickly and you need to start dialysis straight away, your doctor recommends a catheter. Infections, blood clots, and scarring occur in this access more commonly.
   

Hemodialysis At Dialysis Centre Vs Home Hemodialysis. Which Is Best?

There are around five options for hemodialysis. You can choose to do it at a dialysis centre or at home, during the night or a day. Each option has its own advantages and disadvantages. Work with your dialysis care team to find out the best option which suits you.

• Dialysis centre: Health care professionals will assist you in connecting the dialysis machine. Usually, you will have 3 sessions each week. Each session lasts about 4 hours. You will have fixed time slots for your treatment sessions. You have to think about your work and other personal duties when choosing a schedule.
• Night time hemodialysis at dialysis centre: Some dialysis centres offer treatments at night time. You will have your dialysis at night while you sleep. You will have 3 sessions each week. Each session lasts for about 6 to 8 hours. Longer treatment sessions may let you have a better quality of life. Your days are free, and you will have fewer diet changes.
• Standard home hemodialysis: You can do the dialysis with the help of a partner. You and your partner need to be trained for 3 to 8 weeks to handle the machine and for inserting needles. You can choose flexible timing for dialysis sessions. Standard dialysis usually has 3 sessions per week for 3 to 5 hours each time.
• Nightly home hemodialysis: You can plan your dialysis session at night in-home while you sleep. If you have commitments during the day, you may choose this type. Each treatment session lasts for 6 to 8 hours for 3 to 6 times each week.
• Short daily home hemodialysis: Dialysis done for 2 to 4 hours for 5 to 7 days each week.
   

Things To Look Over Before Choosing A Treatment Option:

In in-centre dialysis, Skilled health care professionals will be available with you all time. You can talk with other people who are getting hemodialysis.

The treatment schedule is less flexible. You should plan your work life and personal life according to your schedule. Restrictions in diet will be more. You need to travel to get treatment.

In home hemodialysis, you can choose the treatment time. Flexible timing will help you do other work smoothly and provide space to spend time with your family. Longer sessions will let you have fewer diet limits.

You will need a space to store the dialysis machine and other sterile supplies. The patient  and the care partner are trained from several weeks to a few months to do dialysis safely at home and to handle the problems that may come up. 

Some dialysis centres don’t offer home dialysis support and training. Go through the other treatment options for kidney failure.

Things To Be Taken Care Of During Hemodialysis:

• Care for your vascular access: Whatever the type of access, you need to take good care of it. Check the area for redness or signs of infection. Wash the space around your access with soap and water every day. You will feel a vibration over the area when your access works well. Let your health care team know if you can’t feel the vibration. Do not carry heavy objects that put pressure on the access. 
• Diet changes: You have to limit sodium and phosphorus in your foods during hemodialysis. The amount of liquids you take may need to be limited. You have to add protein to the diet as this kidney dialysis can remove protein. Your doctor may prescribe kidney supplements to help with your nutritional needs.
• Keep track of your weight: You should weigh yourself every day and let your physician know if you weigh much higher or lower than usual. Tracking weight is the best way to check whether your body is holding too much water.
   

Help Yourself:

The important thing that you can do to help yourself is learning. Talk about your treatment options with your doctor to know more, and discuss with your family members to choose the right hemodialysis option for you. Do not skip your treatment sessions. Stick strictly to the meal plan and other care which help you during the treatment.