A machine connected to you in hemodialysis takes the blood from your body, filters it through the dialyzer (artificial kidney) and cleans the blood. It then returns the clean blood to your body. It is a process that takes 3-5 hours . It can take place three times a week in a hospital or dialysis center.

 

You can also perform hemodialysis at home. You may want to spend fewer hours per session, so you may need home treatments four to seven times a week. You may also prefer home hemodialysis while you sleep at night.

How you prepare before hemodialysis 

 

Preparation for hemodialysis begins a few weeks or months before your first procedure takes place. In order to provide easy access to your blood circulation, a surgeon will first open a vein for you.

This intravenous line; It provides the necessary mechanism for some of your blood to be safely removed from your circulatory system and returned to you.

Before hemodialysis, first a dialyzer is set up and sterilization is performed. Before the process starts, approximately 2 liters of serum should be passed through this dialyzer, because it is to purify the dialyzer from the substances used in sterilization.

 Afterwards, the patient who comes for hemodialysis should have an vascular access and this can be done in 3 different ways : 

 

Arteriovenous (AV) fistula 

An AV fistula created using a surgical procedure is the connection between an artery and a vein in your less frequently used arm. This is the preferred type of access because it is secure. It is the most preferred method.

 

AV graft  

If you have blood vessels that are too small to form an AV fistula, the surgeon uses a synthetic tube called a graft instead.Creates apathway between artery and vein

 

Central venous catheter

If you need hemodialysis urgently, a plastic

 

tube (catheter) is inserted into a large vein in your neck. The inserted catheter is temporary.

 

Procedure

 

During the procedure, you can sit or recline in a chair while your blood flows through the dialyzer (filter with artificial kidney function to clean your blood). 

You can do whatever you wish provided that it does not damage the processing.  If you are on hemodialysis at night, you can sleep while the procedure is taking place.

 

  1. Your weight, blood pressure, heart rate and temperature will be checked. The skin on the access surface (the part where the blood leaves during the treatment and then re-enters your body) is cleaned.

 

  1. During hemodialysis, two needles are inserted into your arm through the access point and taped to stay secure. Each needle is connected to a tube, which is flexible plastic that connects to a dialyzer. 

The dialyzer filters your blood through a tube. It allows waste and extra fluids to pass from your blood into a cleansing fluid called dialysate. The cleaned blood comes back to your body with the second tube.

 

  1. You may feel nauseous and stomach cramps due to excess fluid removal from your body (especially if you have taken too much fluid between dialysis sessions). 

If you are feeling uncomfortable during the procedure, talk to your doctor about minimizing side effects by taking precautions such as rearranging your hemodialysis speed, medication, or hemodialysis fluids.

 

  1. As blood pressure and heart rate may change while excess fluid is removed from your body, your blood pressure and heart rate will be checked several times during each treatment phase.

 

  1. When hemodialysis is complete, needles are removed from the entry point and a dressing is applied to the area to prevent bleeding. You are free to continue with your normal activities until the next procedure.

 

                                       References

 

1-  https://my.clevelandclinic.org/health/treatments/14618-dialysis

 

2-  https://www.mayoclinic.org/tests-procedures/hemodialysis/about/pac-20384824

 

3-  https://www.kidney.org/atoz/content/hemoaccess

 

4-  https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis

 

5- https://www.healthline.com/health/dialysis#purpose