Hemodialysis

WHAT YOU SHOULD KNOW:

Hemodialysis is a procedure to remove chemicals, wastes, and extra fluid from your blood. Hemodialysis does the job of your kidneys when they cannot, such as in chronic kidney failure. A machine takes blood from your artery and pumps it through a dialyzer. The dialyzer removes chemicals, waste, and extra fluid from your blood. Once they are removed, clean blood from the dialyzer returns to your body through a vein. You may need hemodialysis for the rest of your life.

AFTER YOU LEAVE:

Medicines:

  • Erythropoietin and vitamins may be given. Erythropoietin is a medicine to replace a similar chemical normally made by healthy kidneys. It may help your body make red blood cells and help prevent anemia (low levels of red blood cells). Your primary healthcare provider (PHP) or nephrologist will tell you if you need to take iron and folic acid medicines. These vitamins may help your body make red blood cells. You may also need to take calcium to prevent or treat bone diseases that sometimes happen with kidney failure.

  • Take your medicine as directed. Contact your PHP if you think your medicine is not helping or you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your PHP or nephrologist as directed:

Write down your questions so you remember to ask them during your visits.

Arteriovenous fistula or graft care:

  • Clean the skin over the fistula or graft each day with soap and water.

  • You may remove the bandage over your fistula or graft 4 to 6 hours after dialysis.

  • Check your fistula or graft each day for good blood flow by touching it with your fingertips. The buzzing sensation means that it is working.

  • Check for bleeding, pain, redness, or swelling. These may be signs of infection or a clogged fistula or graft.

  • Prevent damage to the fistula or graft. Do not let anyone take your blood pressure or draw blood from the arm that has the fistula or graft. Do not sleep on that arm. Do not wear tight clothes or jewelry.

Dialysis diet:

Your PHP will tell you what changes you need to make to the foods you eat. A dietitian can help you plan meals.

  • You will have to limit potassium, phosphorus, sodium (salt), and liquid. You will need more protein than you did before you started dialysis. It may be hard to eat enough food. Your dietitian may suggest that you add extra calories if you are losing weight. Ask your dietitian for more information about a dialysis diet.

  • Ask which liquids to drink, and how much to have. Write down how much liquid you drink each day. Remember to count ice cubes and ice chips. Also count foods that contain liquid. This includes soup, gravy, gelatin, ice cream, and popsicles. Try to drink only when you are thirsty. Limit the amount of caffeine you drink.

  • Suck on hard candy or chew gum to help keep your mouth moist without having to drink liquids. Lemon wedges may also help keep your mouth moist.

Contact your PHP or nephrologist if:

  • You have a fever.

  • You do not feel a buzzing sensation in your fistula or graft.

  • You have chills, cough, or feel weak and achy.

  • Your skin itches or you have a rash.

  • You cannot make it to your follow-up or dialysis visit.

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • Blood soaks through your bandage.

  • The skin around your fistula or graft is painful, hot, red, or swollen.

  • You are urinating little or not at all.

  • You cannot eat or drink because you are vomiting.

  • Your fingers are blue or pale, or they feel cool to the touch.

  • You are breathing fast or have a fast heartbeat.

  • You feel confused, dizzy, or lightheaded.

  • You have sudden chest pain or trouble breathing.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hemodialysis (Discharge Care)

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