Hemodialysis (HD): Types, Procedure, and Recovery Steps
Hemodialysis surgery is a crucial medical procedure that assists individuals with compromised kidney function. When the kidneys struggle to filter waste and excess fluids from the blood, hemodialysis steps in as a lifeline. During the procedure, blood is redirected through a dialysis machine, where it is cleansed of toxins and returned to the body.
Types of Hemodialysis
Here are the main types of hemodialysis:
In-Center Hemodialysis: Performed at a dialysis centre by trained professionals. Patients visit the centre multiple times a week for treatment.
Home Hemodialysis (HHD): Patients perform dialysis at home with proper training and support. This offers more flexibility and convenience.
Nocturnal Hemodialysis: Dialysis is done overnight, either at home or in a centre, allowing for a longer and gentler treatment while the patient sleeps.
Short Daily Hemodialysis: Conducted at home or in a centre, this involves shorter but more frequent sessions, typically 5-7 times a week.
Indications of Hemodialysis Surgery Procedure
Chronic Kidney Disease (CKD): When kidney function deteriorates to stage 5 (end-stage renal disease), hemodialysis is needed to filter waste and excess fluids from the blood.
Acute Kidney Injury (AKI): In cases of sudden kidney failure caused by trauma, infection, or other conditions, hemodialysis may be used to support kidney function temporarily.
Electrolyte Imbalance: Severe imbalances in electrolytes like potassium, calcium, or sodium, which the kidneys can no longer regulate, may require hemodialysis to restore balance.
Toxin Build-Up: When harmful substances, such as drugs or poisons, accumulate in the bloodstream due to kidney failure, hemodialysis helps to remove them.
Fluid Overload: When the kidneys cannot remove excess fluid, causing swelling, high blood pressure, or pulmonary edema, hemodialysis can help remove the extra fluid.
Severe Uremia: Uremia is a condition where waste products build up in the blood. It can cause symptoms like nausea, vomiting, and confusion. Hemodialysis helps clear these toxins.
Chronic Diseases: Conditions like diabetes or high blood pressure that lead to kidney damage may eventually necessitate hemodialysis when the kidneys can no longer function properly.
Hemodialysis is used when kidneys are unable to perform their normal functions and other treatments, such as medications or dietary changes, are insufficient.
Who Will Treat the Hemodialysis Procedure?
To undergo hemodialysis surgery, you would need to connect with a healthcare team that specializes in kidney care and dialysis.
Here’s whom you would typically contact for hemodialysis surgery:
Nephrologist: A doctor specializing in kidney health who assesses function and determines the need for hemodialysis.
Nephrology Department: Hospitals with dedicated departments for kidney care and hemodialysis information.
Primary Care Physician: Provides referrals to nephrologists or dialysis centres.
Medical Referrals: Ask your healthcare provider for recommendations to specialists for hemodialysis.
Internet Research: Find dialysis centers and specialists online.
Healthcare Insurance Provider: Get guidance from your insurance on approved dialysis services.
Local Support Groups: Seek advice from groups for information on local resources and specialists.
How to Prepare for a Hemodialysis Surgery?
Preparing for hemodialysis surgery involves several important steps to ensure that you are physically and mentally ready for the procedure.
Here’s a guide on how to prepare:
Consult with a Nephrologist: Meet with a kidney specialist to discuss the need for hemodialysis.
Medical Evaluation: Undergo tests to assess your health and suitability for dialysis.
Understand the Procedure: Learn about the hemodialysis process and what to expect.
Share Medical History: Provide details about past surgeries, conditions, and medications.
Medication Review: Inform your doctor about all medications, supplements, and herbs you’re taking.
Blood Tests: Complete tests to evaluate kidney function and overall health.
Fasting Instructions: Follow fasting guidelines if instructed by your healthcare team.
Hydration: Stay hydrated to support healing before surgery.
Stop Smoking: Refrain from smoking before and after surgery to aid recovery.
Arrange Transportation: Plan for transport to and from the surgery center.
Arrange Support: Have a family member or friend help during recovery.
Mental Preparation: Understand the benefits and role of hemodialysis in your health.
Preoperative Instructions: Follow guidelines on medication and bathing before surgery.
Communication: Address any concerns or questions with your healthcare team.
Step-by-Step Hemodialysis Procedure
Here is a step-by-step overview of the hemodialysis procedure:
Preparation: The patient is positioned comfortably, and the area where the dialysis access point is located is cleaned and sterilized. The medical team explains the procedure to the patient.
Vascular Access: A needle is inserted into a vascular access point, which could be a fistula (a surgically created connection between an artery and vein), a graft (artificial connection), or a catheter (tube placed into a vein).
Blood Removal: Blood is drawn from the body through the needle and sent to the dialysis machine via tubing.
Filtration Process: Inside the dialysis machine, the blood is filtered through a dialyzer, an artificial kidney, that removes waste products, excess fluids, and toxins from the blood.
Return of Cleaned Blood: The filtered blood is returned to the patient’s body via another needle and tubing.
Monitoring: The patient’s blood pressure, heart rate, and other vital signs are continuously monitored throughout the process to ensure safety and effectiveness.
Completion of Dialysis: The procedure usually takes 3-5 hours, depending on the patient’s needs. Afterwards, the needles are removed, and the access site is covered.
Post-Procedure Care: The patient may rest and is monitored for any complications. The medical team provides instructions on how to care for the access site.
During a Typical Hemodialysis Treatment Session
Vascular Access: Before hemodialysis can begin, a suitable vascular access point is established. This can be done through an arteriovenous fistula (AV fistula), arteriovenous graft (AV graft), or central venous catheter. The access point allows blood to be safely withdrawn from the body and returned after dialysis.
Preparing the Access Point: Needles are inserted into the access site, one to draw blood and the other to return cleaned blood after dialysis.
Connection to Dialysis Machine: The needles are connected to tubes leading to the dialysis machine, where blood is filtered by the dialyzer, mimicking kidney function.
Blood Filtration: Blood flows through the dialyzer, and a sterile solution (dialysate) helps remove toxins and excess fluids from the blood.
Monitoring and Adjustments: Vital signs are monitored, and the dialysis machine is adjusted as needed to ensure the treatment is safe and effective.
Duration of Treatment: The session usually lasts 3-4 hours, depending on individual needs.
Completion of Treatment: Once the blood is cleaned, it’s returned to the body, and the needles are removed.
Post-Dialysis Care: The access site is cleaned and dressed to prevent infection. You may resume regular activities after a short rest.
Recovery After Hemodialysis surgery
Post-Dialysis Fatigue: Some patients may experience fatigue after a hemodialysis session due to the physical demands of the treatment. This is normal and usually improves over time.
Dietary Considerations: Following a specific diet recommended by your healthcare team is crucial to ensure that your body’s nutritional balance is maintained between dialysis sessions.
Fluid Intake Management: It’s important to monitor your fluid intake between dialysis sessions, as excessive fluid intake can lead to fluid overload and potential complications.
Medication Management: If you’re taking medications, it’s important to coordinate their administration with your healthcare team, as some medications might need to be adjusted based on your dialysis schedule.
Lifestyle Adjustments: Adapting to the hemodialysis schedule may require adjustments to your daily routine, especially considering the time and energy spent during dialysis sessions.
Emotional Well-being: Managing a chronic condition like kidney failure and undergoing regular hemodialysis can impact your emotional well-being. It’s important to seek support and engage in activities that bring you joy.
Lifestyle Changes After Hemodialysis Surgery
Dietary Restrictions: Follow a diet plan that limits sodium, potassium, phosphorus, and fluid to manage balance.
Fluid Intake: Monitor fluid intake to avoid overload and heart strain.
Medication Adherence: Take prescribed medications as directed for blood pressure, anemia, and kidney disease.
Regular Appointments: Attend all medical appointments for monitoring and treatment adjustments.
Physical Activity: Stay active as advised to improve circulation and overall health.
Stress Management: Practice stress-reduction techniques like meditation or yoga.
Avoid Smoking and Alcohol: Quit smoking and limit alcohol for better kidney health.
Skin and Access Care: Care for dialysis access sites to prevent infection.
Dental Care: Maintain good oral hygiene to prevent infections.
Vaccinations: Stay updated on vaccines to protect your immune system.
Monitor Blood Pressure: Regularly check blood pressure and manage it with medications.
Education & Self-Care: Learn about your condition and practice self-care.
Limit High-Potassium Foods: Reduce potassium-rich foods like bananas and tomatoes.
Limit High-Phosphorus Foods: Cut back on high-phosphorus foods like dairy and processed meats.
Protein Intake: Adjust protein intake as advised to manage waste buildup.
