Haemodialysis at UHS
Dialysis is a treatment to filter wastes and water from your blood, allowing people with kidney failure to feel better and continue doing the things they enjoy.
In hemodialysis, your blood goes through a filter outside your body and the clean blood is returned to the body.
HEMODIALYSIS is a medical procedure designed to remove wastes, toxins and fluids from the blood when the kidneys have failed. It is the most common treatment for end-stage renal disease (ESRD), more commonly known as kidney failure. Doctors may recommend hemodialysis if your kidneys have failed and can no longer perform the function of removing waste and extra water from the blood to form urine.
Before beginning dialysis, doctors create an “access.” The access serves as a site, usually in the arm, where blood can be safely removed and returned to the body. The access site is often referred to as the “lifeline.” There are four access options: a fistula, a graft, a subcutaneous device or a catheter. Fistulas and grafts are permanent accesses.
A permanent access involves the creation of a connection between an artery and a vein under the skin. These are used for patients with renal failure who are expected to need long-term dialysis treatment. The other types of access, catheters and subcutaneous devices, involve direct placement of a tube into a large vein in the neck, chest or groin. These are used for those who need short-term dialysis or those who are on long-term dialysis and no longer have a place to insert a fistula or graft.
During each dialysis treatment, two needles are inserted into your access. Each needle is connected to a hollow plastic tube. The dialysis machine pumps blood from the body to the hemodialysis machine by way of a flexible, plastic tube. The blood is cleaned and returned to your body through a second tube and needle. (See picture below.)
During the procedure, fluids and waste products are removed from the blood before being returned to the body. The blood is cleaned by a part of the hemodialysis machine known as an artificial kidney or dialyzer, which filters the blood after it has entered the machine. The dialyzer does not completely replace your original kidney’s function.
Remember, your kidneys worked 24 hours a day, seven days a week.
It might look like there is a lot of blood outside your body. Actually, there is only about one cup of blood in the tubing and dialyzer at any time during the treatment.
Just as people are not normally aware of blood moving through the body, you cannot feel blood being pumped out to the machine. Dialysis machines have many gauges and alarms. You may find this overwhelming at first. The machine makes sure your treatment is safe by monitoring your venous pressure, how quickly your blood moves through the tubing and how much water is removed during the treatment.
When will I need to start treatment?
Treatment is needed when someone has stage 5 chronic kidney disease (CKD), or kidney failure. Your doctor can tell your stage of CKD by checking your glomerular filtration rate (GFR). Your GFR can be estimated from the results of a blood test for creatinine, a waste product from muscle activity. If your GFR falls below 15, you are said to have kidney failure (CKD stage 5), and you will need to have some form of treatment to replace the function of your kidneys. If your GFR is less than 30, your doctor should talk to you about the different treatments for kidney failure. Learn all you can to make the best treatment choices for yourself and your family
What does dialysis do to keep me healthy?
Both hemodialysis and peritoneal dialysis do the following:
- Remove waste, salt and extra water to prevent them from building up in your blood
- Keep a safe level of certain chemicals in your blood
- Help to regulate blood pressure
How long will each hemodialysis treatment last?
Hemodialysis treatments are usually done three times a week. Each treatment lasts about four hours, but you may need more time to ensure that enough wastes and fluid are removed. The amount of dialysis you need depends on:
- How much your own kidneys are working
- How much fluid weight you gain between treatments
- How much you weigh
- How much waste you have in your blood
- The type of artificial kidney used by your dialysis center
Your doctor will give you a dialysis prescription that tells how much treatment you need. Studies have shown that getting the right amount of dialysis improves your overall health, makes you feel better, keeps you out of the hospital and enables you to live longer.