Hemodialysis: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
When the kidneys are no longer able to perform this function adequately, hemodilysis is used to remove waste products and excess fluids from the blood. Acute kidney injury (AKI) and end-stage renal disease (ESRD) patients who are unable to function their kidneys properly can benefit from this treatment. An artificial kidney, called a dialyzer, removes toxins and balances electrolytes from blood during hemodialysis.
Preparation
Hemodialysis preparation involves the following steps:
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A vascular access site is established before beginning hemodialysis. In this case, an arteriovenous (AV) fistula, an arteriovenous (AV) graft, or a central venous catheter are used to withdraw blood from the body and return it after filtration.
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Patients undergo a comprehensive medical evaluation to assess their overall health status, including blood tests, imaging studies, and fluid balance and nutrition assessments.
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A dialysis prescription is developed based on the patient's individual needs, including frequency and duration of dialysis sessions, dialysate composition, and target weight loss.
Procedure
Hemodialysis typically involves the following steps:
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The patient's access site is connected to the hemodialysis machine, which pumps blood into the dialyzer.
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Dialysis filters waste products, excess fluids, and electrolytes from blood using semipermeable membranes.
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Through the dialyzer, a dialysate solution contains electrolytes and other substances in concentrations similar to those found in healthy blood. As a result, the blood is kept electrolyte balanced and waste is removed.
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To ensure patient safety and optimal dialysis parameters, vital signs are monitored throughout the procedure, such as blood pressure, heart rate, and oxygen saturation.
Recovery
Patients may experience the following symptoms after hemodialysis:
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Some patients may feel fatigued or weak after dialysis sessions, especially if they have fluid or electrolyte imbalances.
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Hemodialysis removes excess fluid from the body, which may reduce blood pressure, cause dizziness, or cause muscle cramps.
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In order to replenish lost nutrients and maintain adequate caloric intake, patients may require nutritional support after dialysis.
Risks
There are certain risks and complications associated with hemodialysis, including:
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Dialysis can lead to low blood pressure, resulting in symptoms such as dizziness, nausea, and fainting.
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Hemodialysis, particularly with catheter use, is associated with infection at the access site or in the bloodstream.
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Clots may form in the access site or dialysis tubing, potentially causing blockages or vascular complications.
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Dialysis can disrupt electrolyte balance, causing complications such as hyperkalemia (high potassium) or hypokalemia (low potassium).
Aftercare
Patients should follow these steps after hemodialysis:
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In between dialysis sessions, stay hydrated by drinking fluids as recommended by your healthcare provider.
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Manage fluid, electrolyte, and nutrient intake by adhering to dietary restrictions prescribed by healthcare providers.
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Report any unusual symptoms to your healthcare provider promptly, including signs of infection, fluid overload, and electrolyte imbalances.
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Maintain regular follow-up appointments with your healthcare provider in order to monitor your dialysis adequacy, adjust your treatment plan as needed, and address any concerns you may have.
