Hemodialysis is a way to remove wastes from the blood when your kidneys can no longer do the job. It is a lifesaving treatment when you have kidney failure. Hemodialysis is often called dialysis.
Before you can start dialysis, your doctor will need to create a place where the blood can flow in and out of your body during your dialysis sessions. This site is called the vascular access. Your doctor will prepare the vascular access weeks to months before dialysis starts. It is important to get your access as soon as your doctor says to. This allows your access to heal before you use it.
For dialysis to work best, the access needs to have a good, steady blood flow. It also must be sturdy since it will be used often, usually 3 times every week.
Learning about vascular access and dialysis can help you take an active role in your treatment. Dialysis does not cure kidney disease, but it can help you live longer and feel better. You will need to follow your diet and treatment schedule carefully.
The vascular access is where the needles are put that draw the blood from your body and send it through tubes to the dialysis machine. This access is also used to return the clean blood that is sent back into your body. There are two basic types of permanent vascular access:
You will be asleep or get medicine to feel relaxed during the surgery. You will not feel pain. Your doctor will make a cut (incision) on the arm you use the least. If you are right-handed, the fistula or graft will probably be put in your left arm. If you are left-handed, it will probably be put in your right arm. Your doctor will close the incision with stitches. The incision will leave a scar that fades with time.
If you need to start hemodialysis right away, your doctor may place a tube in a vein in your neck, chest, or leg. This is called a central venous catheter. The catheter can be used while your permanent access heals. Catheters have more problems than an AV fistula or AV graft, so they are not the best choice for permanent access.
If you get an AV fistula, you will probably go home the same day as the surgery. If you get an AV graft, you may spend 1 night at the hospital. You will probably need to take 1 or 2 days off from work.
Hemodialysis uses a man-made membrane called a dialyzer to clean your blood. You are connected to the dialyzer by tubes attached to your blood vessels through your vascular access.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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Current as of: March 14, 2018
Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine
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