Haemodialysis

Overview What is hemodialysis? Hemodialysis is a type of During hemodialysis, a machine removes blood from your body, filters it through an artificial kidney (dialyzer) and then returns the cleaned blood to your body. How does hemodialysis work? The dialyzer is the part of the hemodialysis machine that filters your blood. Your blood flows through tiny mesh tubes inside the dialyzer’s core. Waste products and excess fluids in your blood pass through the mesh tubes into dialysate. Dialysate is a fluid that consists of water, salts and electrolytes. Your filtered blood returns to your body. The dialyzer then disposes of the dialysate, which contains your blood’s waste products and excess fluid. What are the two types of hemodialysis? There are two main types of hemodialysis. Talk to your healthcare provider about what type of hemodialysis is best for you. The main types of hemodialysis include: In-center hemodialysis For this type of hemodialysis, you go to a special healthcare facility that specializes in providing hemodialysis. A hemodialysis nurse or technician performs the procedure. Most people get in-center hemodialysis at least three times per week. Each session takes between three and four hours to complete. Home hemodialysis This type of hemodialysis takes place in your home. Over several weeks or months, your healthcare providers will teach you how to perform hemodialysis and resolve common problems that may develop. You then perform the procedure yourself on your o...

Reviewed and revised 21 November 2016 OVERVIEW This page defines and discusses the following Renal Replacement Therapy (RRT) terminology and nomeclature: • extracorporeal circuit • diffusion • ultrafiltration • convection • filtration fraction • sieving coefficient • filter or dialyser • RRT • continuous arterio-venous techniques • IHD • SCUF • CRRT • High volume haemofiltration • high cut-off haemofiltration • SLEDD • predilution • postdilution • middle molecules EXTRACORPOREAL CIRCUIT (EC) • the path for blood flow outside the body • vessel -> catheter -> tubing -> filter/dialyzer -> tubing -> catheter -> vessel DIFFUSION • Diffusion is the movement of molecules from an area of high concentration to an area of low concentration (best for small molecule clearance) • Strictly speaking, dialysis is solute removal by diffusion of the solute across a membrane (however, in clinical settings dialysis usually means a combination of diffusion and convection) • during dialysis the electrolyte solution (dialysate) runs in the opposite direction (countercurrent) to blood flow separated by a semi-permeable membrane. • the rate of mass transfer/diffusion determined by: (1) characteristic of solute (size, charge, protein binding) (2) the dialysis membrane (type, porosity, thickness, surface area) (3) the rate of solute delivery (blood flow rate and dialysate rate –> helps generate concentration gradient) (4) gradient of substance in dialysate to blood Clinical significance • substances...

The two types of hemodialysis are home hemodialysis and in-center hemodialysis. Both types have pros and cons. You should talk with your healthcare team, family, caregivers, or others you trust to help you decide what's best for you. If you choose one type of hemodialysis first, you can usually change to the other. For example, you may start with in-center hemodialysis, but find that you want more freedom with your schedule. If you're able to do the training and meet all the requirements for home hemodialysis, then you can dialyze at home. • Studies show that having dialysis at home 5-7 times a week for shorter periods has much better outcomes, including longer life. • You can also dialyze with the same schedule as in-center. This would include treatments three days a week, with each treatment lasting an average of 4 hours. • You and your dialysis partner learn to do treatments without the need for in-center staff. • Dialysis is done in the comfort of your own home. • No need to travel to a dialysis center. • More flexibility to choose a convenient time to dialyze, including at night. • Greater sense of control from being independent and doing treatment yourself. • A dialysis partner may need to be present while you're on dialysis depending on the type of machine. • Both you and your dialysis partner must attend training. • Room must be made for the machine, water system (if needed), and supplies. • Special electrical connections and plumbing may be needed depending on the...