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: This 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).
  
  
• Vitamins: Your primary healthcare provider 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. Call your primary healthcare provider if you think your medicine is not helping or if 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 primary healthcare provider 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 primary healthcare provider will tell you if you need to be on a special diet. A dietitian can help you with ideas and plan meals.

• You may need to eat foods that are low in sodium (salt), potassium, and protein. Eat foods that contain a lot of fiber. Good examples of foods with fiber are cereal, fruits, and vegetables. Some fruits and vegetables are high in potassium. Ask your dietitian which fruits and vegetables you can eat and how much you can eat.
  
  
• Write down how much liquid you drink each day. Ask your dietitian which liquids to drink, and how much. Remember to count ice cubes and ice chips. 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.
  
  
• Do not drink alcohol. Alcohol can make your kidney failure worse.

For more information:

• • American Association of Kidney Patients
    3505 E. Frontage Rd, Suite 315
    Tampa , FL 33607-1796
    Phone: 1- 800 - 749-2257
    Web Address: http://aakp.org
    
  
  
  
• • National Kidney Foundation
    30 East 33rd Street
    New York , NY 10016
    Phone: 1- 212 - 889-2210
    Phone: 1- 800 - 622-9010
    Web Address: http://www.kidney.org
    

Contact your primary healthcare provider 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.

Learn more about Hemodialysis (Discharge Care)