Your kidneys are like two super filters in our body. The main job of the kidneys is to filter out unnecessary, toxic waste products and excess fluids from the blood. But when these kidneys do not work properly due to certain medical conditions, waste products can accumulate in the body and cause serious problems. This is where the life-saving treatment called hemodialysis comes to our aid.
Simply put, what is hemodialysis?
Hemodialysis is a type of dialysis treatment. When your kidneys can't do their job, a machine is used to clean your blood instead. Simply put, it works like an artificial kidney.
In this procedure, a machine takes some blood from your body, passes it through a special filter (an artificial kidney) to clean it, and then returns the clean blood back to your body. This removes things like nitrogenous waste products (urea), waste products from muscles (creatinine), and acids that accumulate in the blood.
How does this machine purify blood?
Imagine, this is a very amazing technology. The main part of the hemodialysis machine is the dialyzer . This is what we also call the "artificial kidney."
Your blood passes through thousands of very fine mesh-like tubes inside this dialyzer. Then, the waste products and excess water in the blood leak through these fine meshes to a separate side. A special liquid called dialysate is used to collect these waste products. This liquid contains water, salts, and electrolytes.
Your blood, which has been cleaned and removed from waste, is returned to your body through a tube. The dialysate fluid, which has collected the waste, is removed by the machine.
What are the main types of hemodialysis treatment?
There are two main ways to perform hemodialysis treatment. You can discuss with your doctor which method is best for you.
| Treatment method | Description |
|---|---|
| In-center hemodialysis | For this, you will need to go to a hospital or center that specializes in hemodialysis. The treatment is performed by a trained nurse or technician. You will usually have to go about three times a week, and each session will take about 3-4 hours. |
| At home (Home hemodialysis) | This treatment can be done at home. Over the course of a few weeks, doctors and nurses will teach you how to do it and how to deal with any minor problems that may arise. After that, you can do the treatment yourself at your own convenience. |
Are there types of home hemodialysis?
Yes, there are three main types of home treatments.
1. Conventional home hemodialysis: Three times a week, 3-4 hours each time.
2. Short daily home hemodialysis: New technology allows for shorter treatment times. It is done about 5-7 days a week, and takes about two hours per session.
3. Nocturnal home hemodialysis: This is done at night while you sleep. The treatment is done for 6-8 hours at a time, about 4-6 days a week. This method allows the blood to be cleaned for a longer period of time, so more waste products are removed from the body.
How do you prepare before treatment?
Before starting hemodialysis, you need to do some preparation a few weeks or months in advance. The main thing is to find a way to easily and quickly withdraw blood and put it back into the body during the treatment. This involves a minor surgery.
- Arteriovenous fistula (AV fistula): In this procedure, a surgeon connects an artery and a vein in your arm. This is the most suitable and long-lasting method.
- Arteriovenous graft (AV graft): If your artery and vein are too short to be connected together, the surgeon will connect the two using a soft, hollow tube (graft).
If treatment needs to be started urgently, sometimes a soft tube called a catheter can be temporarily inserted into a large vein in the neck, chest, or thigh.
Very important: Your fistula or graft site should be treated like an eye. It is through it that your life-saving treatment is delivered. Therefore, it is essential to protect that area from infection and injury.
To protect your fistula/graft, remember these things:
- Do not sleep with your weight on the side of the arm where the fistula is.
- Do not wear clothing or jewelry (rings, watches) that will get caught in that hand.
- Don't wear a bag strap over that arm.
- Never have your blood pressure (BP) checked or blood drawn from the arm with the fistula.
Do you need to be especially careful about food and drink?
Absolutely yes. The food you eat directly affects the success of hemodialysis treatment. Some foods can increase the amount of waste in the blood, cause water retention, increase BP, and increase heart rate.
Before starting treatment, a renal dietitian will create a diet plan that is right for you. You will usually need to limit foods that contain the following:
| Nutrients to limit | Risks and examples of overdose |
|---|---|
| Potassium | The heart rate can become dangerously fast. For example: banana, avocado, orange, dried fruits, tomatoes. |
| Phosphorus | Bones may become brittle and the skin may become itchy. For example: milk and dairy products, cheese, chicken, canned fish, sausages, lentils, nuts. |
| Sodium - salt | The body needs more fluids (increased thirst), so water retention can occur and BP can increase. For example: salt, sauces added to food, fast food, canned food, salted snacks. |
What are the side effects and complications of the treatment?
As with any medical treatment, there are some possible side effects and complications with hemodialysis. But there is no need to worry about this, as your medical team will constantly monitor you for this.
Common possible side effects:
- Low blood pressure (Hypotension)
- Nausea and vomiting
- Dizziness and fainting (Syncope)
- Chest or back pain
- Headache
- Itching (Pruritus)
- Muscle cramps
- Restless legs syndrome (feeling of restlessness in the legs)
If you experience these symptoms frequently, talk to your doctor or nurse. They may be controlled by changing the pace of treatment or using certain medications.
Possible complications associated with the fistula/graft:
- Infection (redness, swelling, pain, fever)
- Blood clots
- Blockage due to scar tissue
If you see anything like this, you should seek medical advice immediately.
How long can you live with hemodialysis?
This is a problem for many people. The average life expectancy of someone undergoing hemodialysis treatment is about 5-10 years. However, this varies from person to person. There are people who live 20-30 years or even more with good diet, medical advice, and a very good quality of life. Therefore, the most important thing is to stay strong and continue the treatment properly.
Take-Home Message
- Hemodialysis is not something to be afraid of. It is a treatment that works on your kidneys and saves your life.
- Follow the instructions given by your doctor and nutritionist exactly. Diet control is especially important.
- Take good care of your fistula or graft. It is like a gateway to your life. If you notice any changes (pain, swelling, redness), tell your doctor immediately.
- If you are feeling anxious or worried, talk openly with your family and doctor. You are not alone in this journey.
- It is normal to feel tired as a result of treatment, but if it persists, let your medical team know.
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