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Purpose
Hemodialysis cleans and filters your blood using a machine to
temporarily rid your body of harmful wastes, extra salt, and extra
water. Hemodialysis helps control blood pressure and helps your
body keep the proper balance of important chemicals such as
potassium, sodium, calcium, and bicarbonate.
How It Works
Hemodialysis uses a special filter called a dialyzer that
functions as an artificial kidney to clean your blood. During
treatment, your blood travels through tubes into the dialyzer,
which filters out wastes and extra water. Then the cleaned blood
flows through another set of tubes back into your body. The
dialyzer is connected to a machine that monitors blood flow and
removes wastes from the blood.
Hemodialysis is usually needed three times a week.
Each treatment lasts from 3 to 5 or more hours. During treatment,
you can read, write, sleep, talk, or watch TV.
Getting Ready
If you choose hemodialysis, several months before your first
treatment, an access to your bloodstream will need to be created.
You may need to stay overnight in the hospital, but many patients
have their access placed on an outpatient basis. This access
provides an efficient way for blood to be carried from your body
to the dialysis machine and back without causing discomfort. The
two main types
of access are a fistula and a graft.
Possible Complications
Vascular access problems are the most common reason for
hospitalization among people on hemodialysis. Common problems
include infection, blockage from clotting, and poor blood flow.
These problems can keep your treatments from working. You may need
to undergo repeated surgeries in order to get a properly
functioning access.
Other
problems can be caused by rapid changes in your body's water and
chemical balance during treatment. Muscle cramps and hypotension,
or a sudden drop in blood pressure, are two common side effects.
Low blood pressure or hypotension can make you feel weak, dizzy,
or sick to your stomach.
You'll
probably need a few months to adjust to hemodialysis. Side effects
can often be treated quickly and easily, so you should always
report them to your doctor and dialysis staff. You can avoid many
side effects if you follow a proper diet, limit your liquid
intake, and take your medicines as directed.
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Adjusting
to Changes
Even in the best situations, adjusting to the effects of kidney
failure and the time you spend on dialysis can be difficult. Aside
from the "lost time," you may have less energy. You may
need to make changes in your work or home life, giving up some
activities and responsibilities. Keeping the same schedule you
kept when your kidneys were working can be very difficult now that
your kidneys have failed. Accepting this new reality can be very
hard on you and your family. A counselor or social worker can help
you cope.
Many
patients feel depressed when starting dialysis, or after several
months of treatment. If you feel depressed, you should talk with
your social worker, nurse, or doctor because this is a common
problem that can often be treated effectively.
Who Performs It
Hemodialysis is usually done in a dialysis center by nurses and
trained technicians. In some parts of the country, it can be done
at home with the help of a partner, usually a family member or
friend. If you decide to do home dialysis, you and your partner
will receive special training.
Diet
for Hemodialysis
Hemodialysis and a proper diet help reduce the wastes that build
up in your blood. A dietitian is available at all dialysis centers
to help you plan meals according to your doctor's orders. When
choosing foods, you should remember to
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Eat
balanced amounts of high-protein foods such as meat, chicken,
and fish.
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Control
the amount of potassium you eat. Potassium is a mineral found
in salt substitutes, some fruits (bananas, oranges),
vegetables, chocolate, and nuts. Too much potassium can be
dangerous.
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Limit
how much you drink. When your kidneys aren't working, water
builds up quickly in your body. Too much liquid makes your
tissues swell and can lead to high blood pressure, heart
trouble, and cramps and low blood pressure during dialysis.
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Avoid
salt. Salty foods make you thirsty and make your body hold
water.
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Limit
foods such as milk, cheese, nuts, dried beans, and dark colas.
These foods contain large amounts of the mineral phosphorus.
Too much phosphorus in your blood causes calcium to be pulled
from your bones, which makes them weak and brittle and can
cause arthritis. To prevent bone problems, your doctor may
give you special medicines, which you must take with meals
every day as directed.
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