KRISTIAN KARL B.

KIW-IS

Hemodialysis Treatment

In hemodialysis, a machine filters wastes, salts and fluid from your blood when your kidneys are no longer
healthy enough to do this work adequately. Hemodialysis is one way to treat advanced kidney failure and can
help you carry on an active life despite failing kidneys.

Healthy kidneys clean your blood and remove extra fluid in the form of urine. They also make substances that
keep your body healthy. Dialysis replaces some of these functions when your kidneys no longer work. There are
two different types of dialysis - hemodialysis and peritoneal dialysis.

Indication

You need dialysis if your kidneys no longer remove enough wastes and fluid from your blood to keep you
healthy. This usually happens when you have only 10 to 15 percent of your kidney function left. You may have
symptoms such as nausea, vomiting, swelling and fatigue. However, even if you don't have these symptoms yet,
you can still have a high level of wastes in your blood that may be toxic to your body.

Function

Hemodialysis is a procedure where a dialysis machine and a special filter called an artificial kidney, or a dialyzer,
are used to clean your blood. To get your blood into the dialyzer, the doctor needs to make an access, or
entrance, into your blood vessels. This is done with minor surgery, usually to your arm.

The dialyzer, or filter, has two parts, one for your 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 your blood
because they are too big to pass through the membrane. Smaller waste products in the blood, such as urea,
creatinine, potassium and extra fluid pass through the membrane and are washed away.

Diet

Generally speaking, patients on dialysis are advised to increase their protein intake and limit the amount of
potassium, phosphorus, sodium, and fluid in their diet. Patients with diabetes or other health conditions may
have additional diet restrictions. It's important to talk with you dietitian about your individual diet needs.

Risks

 Low blood pressure (hypotension).

 Muscle cramps.
 Itching.
 Sleep problems
 Anemia.
 Bone diseases.
 High blood pressure (hypertension).
  Fluid overload.
 Inflammation of the membrane surrounding the heart (pericarditis).
 High potassium levels (hyperkalemia).
 Access site complications.
 Amyloidosis.
 Depression.

Frequency

In-center hemodialysis. Many people get hemodialysis three times a week in sessions of three to five hours
each.

Daily hemodialysis. This involves more-frequent, but shorter sessions — usually performed at home six or seven
days a week for about two to three hours each time.

Procedure

Preparation. Your weight, blood pressure, pulse and temperature are checked. The skin covering your access
site — the point where blood leaves and then re-enters your body during treatment — is cleansed.

Starting. During hemodialysis, two needles are inserted into your arm through the access site and taped in place
to remain secure. Each needle is attached to a flexible plastic tube that connects to a dialyzer. Through one tube,
the dialyzer filters your blood a few ounces at a time, allowing wastes and extra fluids to pass from your blood
into a cleansing fluid called dialysate. The filtered blood returns to your body through the second tube.

Symptoms. You may experience nausea and abdominal cramps as excess fluid is pulled from your body —
especially if you have hemodialysis only three times a week rather than more often. If you're uncomfortable
during the procedure, ask your care team about minimizing side effects by such measures as adjusting the speed
of your hemodialysis, your medication or your hemodialysis fluids.

Monitoring. Because blood pressure and heart rate can fluctuate as excess fluid is drawn from your body, your
blood pressure and heart rate will be checked several times during each treatment.

Finishing. When hemodialysis is completed, the needles are removed from your access site and a pressure
dressing is applied to prevent bleeding. Your weight may be recorded again. Then you're free to go about your
usual activities until your next session.

Complications

• Infection • Hernias • Nutritional Deficiencies • Low Blood Pressure • Muscle Cramps • Clotting Issues •
Movement Issues • Dry and Itching Skin

Nursing interventions

1. Explain procedure to client

2. Cannulating & connecting to HD machine

3. Monitor hemodynamic status continuously

4. Monitor acid-base balance

5. Monitor electrolytes 6. Insure sterility of system

7. Discuss diet and restrictions on: a. Protein intake b. Sodium intake c. Potassium intake d. Fluid intake

Home remedies

Eating the right foods. Eating properly can improve your hemodialysis results and your overall health. While
you're receiving hemodialysis, you'll need to carefully monitor your intake of fluids, protein, sodium, potassium
and phosphorus. A dietitian can help you develop an individualized meal plan based on your weight, personal
preferences, remaining kidney function and other medical conditions, such as diabetes or high blood pressure.

Taking your medications as prescribed. Carefully follow the instructions from your health care team.