About Hemodialysis

Hemodialysis means “cleaning the blood”. Blood is moved through a machine with a special filter called a dialyzer. The dialyzer removes toxins, excess fluids and electrolytes. The clean blood is then returned to your body. Dialysis helps to control your blood pressure and balance important electrolytes like potassium.

How does the dialyzer clean my blood?

The dialyzer is a large tube that has thousands of small fibers which your blood passes through. Dialysis solution, the cleaning fluid, is pumped around these fibers. The fibers allow wastes and extra fluids to pass from your blood into the fluid that carries them away. The dialyzer is sometimes called the artificial kidney.

Where is hemodialysis done?

Hemodialysis can be done in a hospital, a dialysis center, or even in your home. You and your doctor will decide which place is best for you.

How long are hemodialysis treatments?

The treatments usually take about 3-4 hours and are done 3 times a week. The treatment time depends on:

• How much your kidneys are working.

• How much fluid weight you gain between treatments.

• How much you weigh.

• How much waste you have in your blood.
  

Will the treatments make me feel sick?

Symptoms like cramps, headaches, nausea or feeling dizzy can occur but are not common. If you have these symptoms let your care team know so they can help you. Following your diet and fluid limits will help. Going over your limits will increase the amount of fluid that must be removed during treatment. Too many liquids can also cause severe shortness of breath. Removing extra fluid during dialysis may make you feel sick, so do your best to manage your fluid limits between treatments.

Will hemodialysis change my lifestyle?

You will need time to get used to dialysis and your treatment schedule. The social worker will talk with you about how to adjust to the changes. Once you have adjusted, you should feel a lot better and have more energy for things you enjoy.

Emergencies

In an emergency, your safety is our first concern. In case of a fire, a tornado, or other emergency, we have a plan to respond quickly and carefully. Dialysis staff will help you if an evacuation becomes necessary.

You can help by staying calm and listening closely. The quicker all of us respond, the safer for everyone.

Tips for Travel to and From Dialysis

• Before you begin the trip, be sure to have these supplies with you: a blanket and pillow for rest, emesis basin, Band-Aids, 4x4 gauze pads, and a bottle of drinking water.

• Make sure clothing allows an easy approach to your dialysis access.

• Bring any special cushions you sit on along as well.

• Eating in dialysis is frequently not allowed. Please plan accordingly.

• Avoid eating a heavy meal before dialysis. This can lead to low blood pressures during treatment.
  

When you arrive, staff check your vital signs and weight, and screen you for safety to undergo treatment. Let them know right away if you are not feeling well.

During Treatment

You should not feel any discomfort. Please let the staff know right away if you feel dizzy, cramping, or nausea. These can all be symptoms of taking off fluid too fast. Staff can make changes to help you feel better and may give you IV (intravenous) fluids. We may recline your chair. It is common for people to sit with their feet up to support blood pressure.

After Treatment

We need to know if you are not feeling well in any way. Your vital signs and weight will be rechecked. Blood pressure will be checked while sitting and standing. Big drops in blood pressure can mean that too much fluid was taken. We may give IV fluids to fix this or ask you to sip water to replenish you.

After dialysis, watch for:

• Bleeding at the needle sites. If bleeding, place firm direct pressure on the site for 15 minutes. Do not remove pressure during the 15 minutes. Check the site. If needed, replace the 4x4 gauze pads until the bleeding stops. If the bleeding continues, press on the site for another 15 minutes. If bleeding continues, have someone take you to an emergency room. Do not drive yourself.

• Low blood pressure. You may notice signs of low blood pressure. This might be shaking, blurred vision, dizziness, feeling lightheaded, or nausea. Lay as flat as you can. Sip liquids. Do not eat if you are feeling light headed. If you are driving, pull over right away and do not continue to drive. Put on your flashing lights to signal for help and call 911.

• Nausea and vomiting. Sit up and use an emesis basin. When able, drink clear soda or water.
  

In order to feel your very best, follow your treatment plan as closely as possible. Try not to miss any treatments. Make sure to complete your full treatment time.

Questions to Ask

Please ask any questions you have. Make sure you ask your kidney doctor, dialysis nurse, or dietitian these questions:

• How much fluid can I drink every day?

• What foods should I avoid in my diet?

• Are there foods should I try to eat more of?

• When should I take my blood pressure medications on dialysis days?
  

Please share your thoughts and concerns with the dialysis staff. We are here to help you.