Description
Hemodialysis is a medical procedure used to treat kidney failure by filtering waste products, excess fluids, and toxins from the blood. This process involves diverting blood from the body to a dialysis machine, where it passes through a special filter called a dialyzer. The cleaned blood is then returned to the body. Hemodialysis is typically performed in a hospital or dialysis center, though some patients can perform it at home. This treatment is essential for individuals with end-stage renal disease (ESRD) or severe kidney dysfunction, helping to manage symptoms and improve quality of life. Regular sessions, usually three times a week, are required to maintain the patient’s health and prevent complications.
Summary Listen
- Hemodialysis is a widely known treatment for kidney failure, understood by healthcare workers from nurses to nephrologists. The session aims to clarify aspects of hemodialysis through bilateral communication, covering indications, modalities, apparatus, access, and complications, both chronic and acute.
- Indications for hemodialysis are categorized as acute and chronic. Acute indications include hyperkalemia and metabolic acidosis uncontrolled by conservative management. Chronic indications involve conditions like pericarditis, uropathy, anorexia, nausea, and fluid overload unresponsive to diuretics, where the eGFR is less than 10.
- The primary principles of dialysis involve removing toxins and fluid through diffusion and convection. Diffusion entails solute movement across a membrane from high to low concentration, while convection involves solute movement with fluid. In ESRD, hemodialysis is one of three renal replacement therapies, including peritoneal dialysis, intermittent hemodialysis, hemofiltration, hemodiafiltration, and CRRT.
- Hemofiltration increases convective clearance, enhancing the removal of middle molecules. Dialysis apparatus comprises a dialyzer, dialysis solution (dialysate), tubing, and a machine. Synthetic dialyzers have replaced cellulose-based ones to reduce allergies, and dialysate is prepared online, requiring substantial water.
- Vascular access for hemodialysis includes catheters, fistulas, and grafts. Fistulas, created surgically by joining an artery and vein, are preferred for long-term dialysis due to fewer complications and cost-effectiveness. Grafts, using synthetic materials, are used when native vessels are insufficient but are prone to thrombosis.
- Catheters can be non-cuffed or cuffed. Tunnel catheters are beneficial to mitigate infection rate. Cuffed and tunneled catheters are long term accesses, used to bridge the gap until a fistula can be placed. Common fistula complications include thrombosis, infection, aneurysms, and steel syndrome; tunneled catheter complications involve hematoma, infection, dysfunction, and stenosis.
- Acute complications of hemodialysis encompass hypotension, nausea, vomiting, headache, chest pain, back pain, itching, fever, chills, and muscle cramps. Hemolysis, though uncommon, can occur due to dialyzer issues, necessitating immediate cessation of dialysis and discarding the affected blood.
Sample Certificate
About the Speakers
Dr. Govardhan Gupta
Alumni - Dr. Vaishampayan Memorial Government Medical College
Financial Disclosure
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