Hemodialysis

Hemodialysis is a treatment method that cleanses the body of harmful substances and excess water in individuals with advanced kidney failure. The kidneys normally excrete these substances through urine, but in the case of kidney failure, this excretion does not occur and the substances accumulate in the body. Hemodialysis helps to remove these wastes from the body.

During this treatment, the patient's blood passes through a dialyzer made of a thin membrane. The blood comes into contact with a special liquid (dialysate) inside the dialyzer and the harmful substances pass into this liquid and are removed from the body. A fistula created in the patient's forearm is usually used for hemodialysis. A fistula is a permanent vascular access created by surgically connecting an artery and a vein. A fistula allows hemodialysis treatment to start smoothly and on time. The fistula creation process requires minor surgery and is usually ready for use within a month.

For patients without a fistula, a catheter is placed in the thick veins in the neck or chest cavity when dialysis is required, and a fistula operation is performed after this procedure.

• Sleep disturbances

• Weakness

• Swelling in the legs and face

• Shortness of breath

• Nausea

• Loss of appetite

• Hiccups

• Weight loss

• Abnormal bleeding

If one or more of these symptoms occur, or if your doctor warns you based on your lab tests, you may need dialysis.

Getting enough dialysis is critical to maintaining your health and living a long life. Getting enough dialysis:

• Makes you feel better and helps you perform your daily activities more effectively.

• Supports a long and quality life.

• Prevents medical problems that may require hospitalization.

Whether you are getting enough dialysis is determined by measurements such as Kt/V, URR, or urea reduction rate, taken by your dialysis team. These measurements are usually taken once a month by taking blood samples. You may also be asked to collect urine. It is important to know that your Kt/V must be at least 1.2 and your URR must be at least 65%. Hemodialysis is usually performed 3 times a week, and each session is usually 4 hours or longer. Shortening your dialysis time can lead to health problems.

If the measured values ​​are below the targets, your dialysis team can check the following:

1. Does your vascular access provide adequate blood flow?

2. Is your dialyzer suitable, is it possible to use a larger dialyzer?

3. Is your dialysis duration sufficient, or are you leaving sessions early?

4. Can your dialysate rate be increased?

5. Have your blood samples been taken appropriately?

Interruption of your hemodialysis sessions may negatively affect your dialysis adequacy.

Your dialysis team creates a personalized treatment program for you. This program:

1. Determines what type and size of dialyzer you need.

2. Regulates the speed of blood and dialysate.

3. Determines how many times per week and how long each session will last.

The urea kinetic model (UKM) is usually used to calculate your dialysis dose correctly. Blood samples are taken during dialysis and urine is collected if necessary to calculate how much urea has decreased in your blood. In addition, your weight before and after dialysis is taken into account to calculate the Kt/V value. This calculation:

1. Helps you plan your treatment better.

2. Eliminates errors in reaching the target dialysis dose.

3. Your dialysis center can also make dose adjustments using the URR measurement.

In addition to Kt/V and URR, your dialysis team will also perform blood and urine tests to help plan your treatment. They will also monitor your weight and blood pressure before, during, and after dialysis. Keeping track of your important test results on a tracking card can help you keep track of your own health.

To ensure that you have a comfortable treatment experience during dialysis, your team tries to prevent symptoms such as cramps, nausea, headaches and dizziness. When these symptoms occur, you can notify your physicians so that they can make the necessary changes.

• Adjusting the rate of fluid withdrawal

• Increasing the amount of sodium in the dialysate

• Reviewing your hypertension medications

• Regulating your dry weight

• Reducing the temperature of the dialysate