Hemodialysis: What to Expect During Treatment

When the kidneys are no longer able to adequately filter waste products and excess fluid from the blood, hemodialysis becomes necessary to maintain overall health and well-being. This intervention is a vital procedure to save the patient's life due to failing kidneys.

Now most of you might be wondering if every patient with kidney condition must undergo hemodialysis. That is a great question, which we'll cover later on. At the same time, we'll provide you more about the process and its course of treatment.

So if you do have kidney conditions, read this guide to know more. Let's begin!

What is Hemodialysis

Hemodialysis is a type of dialysis that helps remove waste products and excess fluid from the blood when the kidneys are no longer able to perform this function adequately. It is commonly used to treat advanced kidney failure and is often referred to as "dialysis." Take note that it can help improve the patient's quality of life, allowing them to continue leading active lives despite their failing kidneys.

The kidneys play a crucial role in maintaining the body's overall health. They filter waste products, such as urea and creatinine, from the blood and help regulate the balance of electrolytes and fluid in the body. When the kidneys are no longer able to perform these functions effectively, waste products and fluid build up in the blood, leading to various health complications.

This procedure is recommended by doctors as it can help remove these waste products and excess fluid, improving the overall well-being of the patient. By simulating the function of the kidneys, hemodialysis helps restore the balance of electrolytes and fluid in the body, allowing patients to lead active lives and manage their condition effectively.

What Is Hemodialysis and How Does It Work?

The process of hemodialysis involves several important components, including vascular access, which is necessary to connect the patient's bloodstream to the dialysis machine. This can be achieved through an arteriovenous (AV) fistula, an av graft, or a venous catheter. Vascular access provides a pathway for the blood to be safely removed from the patient's body and returned after undergoing the filtration process.

During hemodialysis, the patient's blood is pumped out of their body and into the dialysis machine, where it passes through a filter called a dialyzer. The dialyzer removes waste products and excess fluid from the blood, and the clean blood is then returned to the patient's body. This process helps maintain a healthy balance of electrolytes and removes toxins that the kidneys can no longer filter effectively. Hemodialysis typically takes place at a dialysis center or can be done at home with proper training and equipment.

Common Conditions Leading to Hemodialysis

There are several common conditions that can lead to the need for hemodialysis. These conditions can impair kidney function to the point where hemodialysis is necessary to help filter waste products and maintain fluid balance in the body.

If you are in the severe stage of any of the following conditions, it is ideal to seek help to know whether or not you need to undergo hemodialysis.

Diabetes and High Blood Pressure: The Leading Causes

Diabetes and high blood pressure are the leading causes of kidney disease. Both conditions can affect kidney health, impairing its ability to filter waste products and regulate fluid balance in the body.

In the case of diabetes, patients with these conditions suffer from high levels of blood sugar. This scenario can cause damage to the blood vessels of the kidneys over time. Once that happens, kidneys will not function well. Thus, filtration of waste is not possible.

Meanwhile, high blood pressure or hypertension can affect the blood vessels. The condition can constrict the vessels, leading to reduced blood flow. Of course, it doesn't only affect the blood vessels in the kidneys, but other organs as well. In the case of kidney blood vessels, if there's no blood flow, it can result in damaged vessels. In short, the kidney can't receive blood flow and perform its duty.

Managing diabetes and high blood pressure through lifestyle changes and medications can help slow the progression of kidney disease and delay the need for hemodialysis. However, in cases where kidney function has significantly declined, hemodialysis may be necessary to maintain overall health and well-being.

Other Conditions That May Necessitate Hemodialysis

In addition to diabetes and high blood pressure, there are other conditions that can result in the need for hemodialysis. Acute kidney injury, also known as acute renal failure, occurs when the kidneys suddenly lose their ability to function properly. This can happen as a result of severe illness, injury, or certain medications.

Additionally, conditions like chronic kidney disease can also progress to a point where the kidneys no longer function well enough to sustain life. This is known as renal failure. Renal disease, which encompasses various conditions affecting the kidneys, can also lead to the need for hemodialysis.

Take note that if kidney function is severely impaired or has been lost completely, hemodialysis becomes necessary to filter waste products and maintain fluid balance in the body.

Signs That You May Need Hemodialysis

Aside from suffering from the mentioned conditions, there are more specific signs that indicate the need for hemodialysis. Here are the possible scenarios that apply:

Kidney failure

Decreased urine output, swelling in the legs or ankles, and persistent fatigue can be signs of kidney failure. When the kidneys are no longer able to filter waste products and excess fluid, these symptoms can occur.

Extra fluid

If the kidneys are not functional, it can lead to a buildup of fluid in the body. The excess fluid can lead to symptoms such as shortness of breath, swelling in the legs or ankles, and sudden weight gain.

If you experience any of these signs or symptoms, it is important to consult with your healthcare provider. They can evaluate your kidney function and determine if hemodialysis is necessary to help manage your condition.

Preparing for Your First Hemodialysis Session

Preparing for your first hemodialysis session involves several important steps to ensure a smooth transition to the treatment. Here are some key things to consider:

1. Choosing a dialysis center: Your healthcare team will help you find a dialysis center that suits your needs. It's important to choose a center that is convenient for you to access and offers the services and support you require.
2. Dialysis education: Before starting hemodialysis, you will receive extensive education and training on how to manage the treatment. This includes learning about the dialysis machine, understanding the purpose of each component, and becoming familiar with the dialysis process.
3. Vascular access: The doctor will perform a procedure to have a vascular access created. This is a surgical procedure to create a site on your body where the blood can be accessed for the treatment. The two common types of vascular access are an arteriovenous (AV) fistula and a venous catheter.

• An AV fistula is created by surgically connecting an artery to a vein, usually in your arm. This allows for efficient blood flow during hemodialysis.
• A venous catheter is a temporary access that is placed in a large vein, usually in your neck or chest. It is used for immediate hemodialysis access while waiting for an AV fistula to mature.

Other preparations may vary depending on the instructions that the doctor will provide. So, it's best to pay attention during the consultation and dialysis education session to be well informed and prepared.

What Happens During a Hemodialysis Session?

During a hemodialysis session, several important steps are involved to ensure the effective removal of waste products and excess fluid from the blood. Here is an overview of what happens during a typical hemodialysis session:

• Preparation: Before the session begins, your weight, blood pressure, pulse, and temperature will be checked. The skin covering your access site will be cleansed to prevent infection.
• Starting: Needles will be inserted into your access site, and each needle will be attached to a flexible tube that connects to the dialysis machine. One tube carries the blood to the machine, while the other tube returns the filtered blood to your body.
• Symptoms: During the session, you may experience symptoms such as nausea, abdominal cramps, or muscle cramps as excess fluid is pulled from your body. If you experience discomfort, your dialysis care team can adjust the speed of your treatment or provide medication to alleviate these symptoms.
• Monitoring: Throughout the session, your blood pressure and heart rate will be closely monitored to ensure they remain stable. Blood tests may also be conducted to assess the effectiveness of the treatment and make adjustments if necessary.
• Finishing: Once the desired amount of fluid has been removed and the dialysis session is complete, the needles will be removed from your access site, and a pressure dressing will be applied to prevent bleeding. Your weight may be recorded again, and you will be able to go about your usual activities until your next session.

The length and frequency of hemodialysis sessions can vary depending on individual needs and the recommendation of your healthcare team. The goal is to achieve and maintain a dry weight, which is the weight of your body without the excess fluid that can accumulate in between sessions.

Life with Hemodialysis

Hemodialysis is not a one-time procedure. The procedure will possibly involve about 4 - 7 times a week of undergoing hemodialysis. Although, that duration can still change depending on your health status and what the doctor will recommend. At the same time, hemodialysis usually lasts about 4 hours per session, making the patients feel more tired.

Adjusting to the Hemodialysis Routine

Patients suffering from kidney failure may experience difficulties when adjusting to the hemodialysis routine. However, having the right support and resources can help it to become a manageable part of your life.

Here are some of the key aspects you might want to consider to adapt this experience better in your daily life.

Nocturnal Hemodialysis

Some individuals may opt for nocturnal hemodialysis, which involves receiving treatment overnight while sleeping. Nocturnal hemodialysis offers the advantage of longer treatment times, allowing for more efficient removal of waste products and excess fluid. It can also provide a more continuous and gentle treatment experience compared to shorter daytime sessions.

Dialysis Treatment Schedule

It is important to establish and maintain a consistent dialysis treatment schedule. This helps ensure that your body receives the necessary filtration and removes waste products and excess fluid effectively. Work closely with your healthcare team to establish a schedule that works best for you and consider any personal preferences or commitments you may have.

Meal Plan

Following a healthy and balanced meal plan is a crucial aspect of managing hemodialysis. Your healthcare team, including a registered dietitian, can help develop a meal plan that meets your specific nutritional needs while considering any dietary restrictions or recommendations based on your individual case. Proper nutrition is an essential component of overall health and well-being for individuals on hemodialysis.

Health Care Team Support

Your health care team, including your nephrologist, dialysis nurses, dietitian, and social worker, is there to provide support and guidance throughout your hemodialysis journey. They can offer resources, education, and assistance in managing any challenges or concerns that you may have. Building a strong and trusting relationship with your health care team can significantly contribute to a positive experience with hemodialysis.

Managing Side Effects and Ensuring Effective Treatment

Like other medical procedures, hemodialysis might also affect the patients through the following side effects. Undergoing several sessions of hemodialysis can result in fatigue due to the long duration of sessions. Thus, it can also result in muscle cramps. On the other hand, some also experience low blood as a side effect of the treatment.

So how to manage these side effects? Here's how:

Fatigue Management

This case can be managed through various interventions, including adjusting the dialysis prescription, dietary changes, or medication management. Your health care team will work closely with you to minimize side effects and optimize your treatment.

Blood Pressure Management

Hemodialysis can have an impact on blood pressure, and it is important to monitor and manage blood pressure levels closely. Your health care providers may prescribe medications or recommend dietary changes to help maintain stable blood pressure during hemodialysis.

Muscle Cramp Prevention

Meanwhile, in terms of muscle cramps, it can also occur during hemodialysis sessions. Although, there are strategies to help prevent and manage them. Maintaining proper hydration, adjusting dry weight, and ensuring adequate intake of necessary nutrients can help minimize muscle cramps. Your health care team can provide guidance on specific interventions and strategies.

Frequently Asked Questions

How long does a patient typically need hemodialysis?

The duration of hemodialysis treatment varies depending on individual circumstances. Some individuals may require hemodialysis for a short period of time, while others may need it on a long-term basis. Factors such as the underlying cause of kidney disease, overall health, and the availability of a kidney transplant can influence the duration of hemodialysis treatment.

Can hemodialysis completely replace kidney function?

The procedure can partially replace kidney function by removing waste products and excess fluid from the blood. However, it cannot completely replicate the intricate functions of healthy kidneys. Other types of dialysis, such as peritoneal dialysis, may also be used to manage kidney disease, but they cannot fully restore normal kidney function.

Is it possible to lead a normal life while undergoing hemodialysis?

While living with hemodialysis requires adjustments and adherence to treatment, it is possible to lead a fulfilling life. With proper management and support, individuals on hemodialysis can continue to engage in their daily activities, pursue personal interests, and maintain a good quality of life. Support from a social worker can be beneficial in addressing any concerns or challenges that may arise.

Understanding the hemodialysis process is crucial for both patients and their loved ones. Remember, kidneys are vital organs that can help your body to function better. However, if it is not functional, it can result in bigger problems. That's why knowing when to seek help for a hemodialysis must happen.

If you have been suffering from the mentioned conditions and have the 2 common signs, it is highly imperative to undergo this health procedure. Book a consultation with a hemodialysis doctor today!