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What you need to know about hemodialysis:
Hemodialysis is a procedure that uses a machine to do the job of your kidneys. The machine pumps your blood through a dialyzer, or artificial kidney. The dialyzer filters fluid, salts, and waste from your blood. Once they are removed, clean blood from the dialyzer returns to your body through a vein. You may need hemodialysis short-term or for the rest of your life. You may need to make changes to your diet and take your medications at the same times. You will work with a team of specialists and may be able to do hemodialysis at home.
What needs to be done weeks to months before hemodialysis:
You may need surgery to make an arteriovenous fistula (AVF). An AVF connects an artery directly to a vein. You may also need surgery to place an arteriovenous graft (AVG) in your arm. An AVG is an artificial tube that connects an artery directly to a vein. The AVF and AVG act as bridges for blood to go from your body to the hemodialysis machine, and back to your body. You may need a central venous catheter (CVC) if you need hemodialysis quickly. A CVC is a temporary catheter that is placed into a large vein in your neck or groin.
What is done the day of hemodialysis:
Your weight, temperature, pulse, and blood pressure will be checked. Your access will be checked. The access site is where the blood leaves and returns to your body. You will be able to sit or recline in a chair during hemodialysis. You may sleep during the procedure if it is at night.
How often do I need hemodialysis:
You and your healthcare provider will work together to pick the right hemodialysis schedule:
- The usual hemodialysis schedule has 3 sessions each week. Each session lasts 4 to 6 hours. The sessions are usually done in a hospital or hemodialysis center.
- Short daily hemodialysis has 6 sessions each week. Each session lasts 2 to 3 hours. The sessions may be done in a hospital, hemodialysis center, or your home.
- Nightly hemodialysis can be up to 6 sessions each week. Each session lasts 8 to 10 hours. This may be done in a hospital, a hemodialysis center, or in your home. The sessions are done at night, while you sleep.
Where do I get hemodialysis:
You can choose to have hemodialysis at a hospital, hemodialysis center, or possibly in your own home. You will need the right training and proper equipment to do hemodialysis in your home. You will have to check yourself before, during, and after hemodialysis. You will also need to know how to respond to alarms from the hemodialysis machine. You will need to know what to do if you are not feeling well, and when to call your healthcare provider for help. Your healthcare provider will make sure you are well prepared before he lets you do hemodialysis at home.
What happens after hemodialysis:
You may have a bandage on your access site after hemodialysis. If your access site starts to bleed, apply gentle pressure with a towel or gauze for 10 to 15 minutes. If a scab forms when it heals, do not pick it off. This can increase your risk for bleeding or infection.
Call 911 for any of the following:
- You have sudden chest pain or trouble breathing.
- You are breathing fast or have a fast heartbeat.
- You feel confused, dizzy, or lightheaded.
Seek care immediately 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.
- Your fingers are blue or pale, or they feel cool to the touch.
Contact your healthcare provider 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.
- Medicines and vitamins may help prevent anemia (low level of red blood cells).
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him of her 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.
AVF or AVG care:
- You may remove the bandage over your fistula or graft 4 to 6 hours after dialysis.
- Clean the skin over the fistula or graft each day with soap and water.
- 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 healthcare provider will tell you what changes you need to make to the foods you eat. A dietitian can help you plan meals.
- Eat foods as directed. You may need extra calories or protein. Limit potassium, phosphorus, and sodium (salt). You may find it hard to eat enough food. Talk to your healthcare provider or dietitian for help or more information about nutrition for dialysis.
- Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Keep a record of how much liquid you drink each day. Count ice cubes, soup, gravy, gelatin, and popsicles. Limit caffeine.
- Keep your mouth moist. Suck on hard candy or lemon wedges, or chew gum.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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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.