Hemodialysis For Acute Renal Failure
WHAT YOU SHOULD KNOW:
Hemodialysis is a procedure to remove chemicals, wastes, and extra fluid from your blood. Hemodialysis does the work of your kidneys when they are not working, such as with acute renal (kidney) failure. Acute renal failure develops when your kidneys suddenly stop working. Failure happens quickly, within hours or days. The hemodialysis machine takes blood from your artery and pumps it through a dialyzer. The dialyzer removes chemicals, waste, and extra fluid from your blood. Clean blood from the dialyzer returns to your body through a vein.
AFTER YOU LEAVE:
- Vitamins may be given. 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:
Your PHP will tell you how frequently your hemodialysis catheter will need to be replaced. If you need more dialysis sessions, you may need to have surgery to make an arteriovenous fistula (AVF) or arteriovenous graft (AVG). If you had surgery for an AVF or AVG, your PHP or nephrologist needs to check to make sure it is healing properly. Write down your questions so you remember to ask them during your visits.
AVF or AVG care:
When your AVF or AVG is healed and working well, you may need to care for it by yourself. Follow these instructions:
- Clean the skin over the fistula or graft daily with soap and water.
- Take the bandage off the 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.
Your PHP will tell you if you need to be on a special diet. A dietitian can help you plan meals.
- You may need 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 have chills, a cough, or feel weak and achy.
- You do not feel a buzzing sensation in your fistula or graft.
- Your skin is itchy or has a rash.
- You cannot make it to your next 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 cannot eat or drink because you are vomiting.
- You are urinating little or not at all.
- Your fingers are blue or pale, or they feel cool to the touch.
- You are breathing fast or have a fast heartbeat.
- You are confused, dizzy, or lightheaded.
- You have sudden chest pain or trouble breathing.
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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.