Hemodialysis

The function of normal healthy kidneys involves filtering blood and eliminating excess fluid in urine form. They also produce vital substances that help maintain the body in a healthy state. If the kidneys fail to work, as usual, medical providers can recommend hemodialysis to replace essential kidney functions. 

Hemodialysis is one of the most prominent forms of dialysis. It involves the use of a hemodialyzer (artificial kidney) to get rid of waste and excess fluid from the blood. Through the artificial kidney, the blood is filtered and eliminated from the body. The filtered blood will then be put back into the body using the dialysis equipment. 

Why does Hemodialysis Involve?

Before starting the hemodialysis process, minor surgery to obtain vascular access is necessary. This creates a path in which the blood will flow inside and out of the body through the dialysis machine. 

The hemodialysis technician will insert two needles in the arm with vascular access at the beginning of every treatment. The blood will then flow via one of the needles from the vascular access into the dialysis device. It will also flow back into the body from the dialysis equipment via the other needle. 

Basically, there are three categories of vascular access, including; 

• AV (arteriovenous) fistula

This is the safest mode of vascular access. Normally, it could last for several years with a low risk of infection or formation of blood clots. During the procedure, the physician will link an artery and a vein beneath the skin of the arm. The physicians usually perform the AV fistula process in the non-dominant arm. For a right-handed patient, the fistula is most likely to be in the left arm.

Since the fistula requires some time to recover following surgery, you can have an AV fistula two to three months before starting the dialysis. After this duration, the fistula will become strong enough compared to the normal vein or artery. This enables the needles to be inserted and removed several times a week. 

• AV graft

This is another safe and effective vascular access alternative. Unlike AV fistula, it is most likely to develop problems due to infections and the formation of blood clots. The surgeon will use a plastic tube to join the vein and artery underneath the skin of the arm. Usually, it’s advisable to receive an AV graft at least two to three weeks before starting dialysis.

• Catheter 

A catheter is a flexible Y-shaped tube. These catheters are highly susceptible to issues with blood clots, scarring, and infection. One end of the catheter links to a major vein deep inside the body. The other two ends emerge from the skin. 

Catheters are classified into two types, including; 

A venous catheter: This is a tube that links to a vein in the chest, neck, or leg. It also hangs from a hole in the skin outside the body. 

A tunneled catheter: This normally links to the vein in the neck. Unlike the venous catheter, it is much safe and could be useful for extended periods.

What to Expect When Undergoing Hemodialysis 

One can receive hemodialysis treatment while at home, in the hospital, or dialysis center. The frequency of the procedure can vary from one patient to another based on the health situation. The treatment is mostly categorized into the following; 

Daily hemodialysis: This includes frequent yet short sessions. It’s normally done while at home and can take about 6 to 7 days per week. Each treatment session lasts for 2 to 3 hours. 

In center hemodialysis: With this, patients will receive hemodialysis at least three times a week. Each session takes about 3 to 5 hours. 

You will recline or skit on a chair during the treatment procedure as the blood flow via the dialyzer. The dialyzer functions as an artificial kidney that cleans and purifies the blood. During this period, one can take a nap, read a novel, watch a movie, or even have a chat. 

Overall, this is what you should expect when undergoing a hemodialysis procedure; 

• Preparation

The doctor will first check and analyze your blood pressure, weight, heartbeat, and temperature. The skin over the access site is cleansed. This is the place where blood exits and re-enters the body during the procedure.

• The process

The doctor inserts two needles into the arm via the access point and tapes them in place to ensure safety during hemodialysis. Each of the needles is connected to a dialyzer, hemodialysis device, through an elastic plastic tube. The dialyzer cleanses the blood a few ounces at a time through one of the tubes. This enables wastes and excess fluids to flow from the blood towards the cleaning fluid known as dialysate. After that, the purified blood goes back to the body via the other tube. 

• Potential symptoms

You are likely to experience abdominal cramps and nausea when the extra fluid is removed from your body. This is particularly if you only undergo hemodialysis treatment three days per week instead of more frequently. If you feel uncomfortable during the process, speak to your doctor about ways to minimize the side effects. This could be through changing the speed of the hemodialysis, the dosage, or the hemodialysis fluids. 

• Monitoring

The heart rate and blood pressure might fluctuate as extra fluid is eliminated from the body. Due to this, they are checked multiple times during every treatment. 

• Concluding

Once the hemodialysis treatment is complete, the doctor will remove the needles from the access site. They will also apply a pressure dressing to help avert bleeding. If necessary, they might measure and re-record your weight. After that, you will be free to resume your daily activities till the next hemodialysis session. 

Hemodialysis Results 

People who suffer from sudden or acute kidney injury might require hemodialysis for a shorter period until the kidneys heal. On the other hand, people who experience reduced kidney function before acute injury have limited chances of fully recovering. 

While in-center hemodialysis is more prominent, certain medical studies state that home dialysis could be associated with; 

• Enhanced well-being 
• Improved quality of life 
• Alleviated symptoms and reduced headaches, cramping, or shortness of breath 
• Better sleeping patterns, appetite, concentration abilities, and energy level 

The hemodialysis care team keeps track of the procedure to ensure that you have adequate hemodialysis amounts to clear wastes from the blood. Your blood pressure and weight are closely monitored before, during, and after the procedure. 

Risks Associated With Hemodialysis 

Most of the patients who require hemodialysis treatment often have a range of health conditions. Hemodialysis thus aims at prolonging the life of the people suffering from kidney failure. However, the life expectancy for the individuals who need the procedure is relatively smaller than that of the overall population. 

Although this treatment might be efficient when it comes to replacing lost kidney functions, one can experience associated conditions. Nonetheless, not every patient will experience all the related diseases. They can include the following; 

Hypotension (low blood pressure): Blood pressure drop is a frequent side effect of hemodialysis, especially in patients with diabetes. Shortness of breath, muscle cramps, abdominal cramps, nausea, or vomiting may accompany low blood pressure.

Muscle cramps: Muscle cramps are common during hemodialysis, but the cause is unknown. The cramps can be relieved by changing the hemodialysis prescription. Also, adjusting sodium and fluid consumption during hemodialysis treatments can help avoid certain symptoms. 

Itchiness: Often, most hemodialysis patients experience itchy skin, which is usually extreme during or immediately after the treatment.

Sleeping disorders: Patients undergoing hemodialysis treatment often experience difficulties sleeping. This could be due to breaks or delays in breathing while asleep (sleep apnea) or due to aching, discomfort, or restlessness in the legs.

Anemia: This condition is associated with a deficiency of red blood cells in the blood. It is a major complication related to hemodialysis and kidney failure. Kidney failure decreases the production of erythropoietin, a hormone that promotes the creation of red blood cells. Dietary limits, low iron absorption, repeated blood testing, or hemodialysis removal of iron and vitamins may lead to anemia.

Hypertension (high blood pressure): The blood pressure level is likely to increase if you take too much sodium or drink a lot of fluid. This can result in strokes and heart issues. 

Bone disease: The bones can weaken if your kidneys can no longer process vitamin D, which aids in calcium absorption. Furthermore, excess production of parathyroid hormone, a frequent complication associated with kidney failure, may cause calcium release from the bones.

Other hemodialysis side effects and potential health conditions include; 

• Pericarditis (inflammations of the membrane that surrounds the heart)
• Overload of the fluid 
• Hyperkalemia (high levels of potassium)
• Amyloidosis 
• Complications of the access site 
• Depression 

Conclusion 

Hemodialysis is a procedure to remove wastes and excess fluids from the bloodstream if the kidneys no longer function appropriately. It’s one of the best methods of treating complex kidney failure and ensuring normal life regardless of the failing kidneys. 

For hemodialysis treatment to work accordingly, you will have to make a few adjustments based on the doctor’s instructions. They can include taking drugs regularly, adhering to a strict treatment plan, and making some diet changes.