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.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may have an allergic reaction to the medicines or dialysate to be used. An allergic reaction may cause your skin to get red and itchy, and you may suddenly have trouble breathing. During hemodialysis you may vomit, have a headache or seizure, or feel very tired. Your blood pressure may drop too low or go too high. You may have chest pain, trouble breathing, and your heart may not beat properly. You may get an infection or have bleeding inside your abdomen. You may have muscle cramps or pain in your arms and legs.

  • If you do not have hemodialysis, your body will continue to hold excess water and unwanted chemicals and wastes. Your body may swell, starting from your feet. You may have heart problems, chest pain, and trouble breathing. You may have seizures, trouble thinking, or go into a coma. These problems may be life-threatening.

Getting Ready

The week before your hemodialysis:

  • Write down the correct date, time, and location of your procedure.

  • Your caregiver will need to check your arteriovenous fistula (AVF) or arteriovenous graft (AVG) to make sure it is working well. The fistula and graft are where your caregiver puts needles during dialysis. Blood will go out from and come back to the AVG or AVF after being cleaned by the hemodialysis machine.

  • You and your caregiver will create a hemodialysis schedule, or how frequently you need to have hemodialysis. Your caregiver will suggest a schedule based on your condition.

  • Your caregiver will let you choose to have hemodialysis in a special center or possibly at home. You and your caregiver will talk about what is best for you. Your caregiver will first make sure you are properly trained and have the right equipment before he will let you have hemodialysis at your home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Arrange for someone to drive you home after your procedure. Do not drive yourself home.

  • You may need to have blood and urine tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your hemodialysis:

Ask caregivers about directions for eating and drinking.

The day of your hemodialysis:

  • Ask your caregiver before you take any medicine on the day of your hemodialysis. These medicines include insulin, diabetic pills, high blood pressure pills, and heart pills. Bring all the medicines you are taking with you to the hospital. Bring them in their original bottles or containers.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

  • Your caregiver will check that you are ready for the hemodialysis. You will be asked to sit back on a comfortable reclining chair. Your caregiver may give you medicine to keep your blood from clotting in the tubes. He will then clean the area over your arteriovenous fistula (AVF) or arteriovenous graft (AVG). He will insert and tape 2 needles in place. He will connect the tubes from the machine to the needles and start the hemodialysis.

  • During hemodialysis you may read, watch TV, or take a nap. Your caregiver will check on you several times to make sure you are okay. He will also check on the machine several times to make sure it is working properly. Alarms may sound if your blood pressure or pulse change too much, or if the tubing gets loose or kinked. Do not be afraid when the alarms go off. Your caregivers will find the problem, turn off the alarm, and continue your hemodialysis.

After your hemodialysis:

When your hemodialysis is finished, the needles will be removed from your arm. A bandage will be wrapped tightly over it. You may have to wear this bandage for a couple of hours. You may also have to rest for some time until your caregiver sees that you are ready to go home.

Contact a caregiver if

  • You have a fever.

  • You cannot make it to your appointment on time.

  • You feel very tired most of the time.

  • You get a cold or the flu.

  • You have a metal taste in your mouth.

  • You have questions or concerns about your hemodialysis.

Seek Care Immediately if

  • The problems for which you are having hemodialysis get worse.

  • You have chest pain or trouble breathing.

  • You gain a lot of weight very fast.

  • You suddenly have a seizure, become confused, or lose consciousness.

  • Your legs suddenly become swollen.

© 2014 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 (Precare)

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