HomeDialysisHow to care for Hemodialysis patients? Hemodialysis vs Dialysis

How to care for Hemodialysis patients? Hemodialysis vs Dialysis

Hemodialysis is an extracorporeal dialysis method for care of Hemodialysis patients, with chronic renal failure. It allows you to remove protein and mineral catabolism products and excess water consumed.

3.5 – 5 hours Hemodialysis patients, in which the main mechanism of substance exchange in the dialysis is diffusion occurring through the semi-permeable dialysis membrane, is considered “classical” hemodialysis.

Care for hemodialysis patients

Take into account the patients’ learning needs and deliver therapy instruction. Make a plan for care for hemodialysis patients. offer the patients the medications that their doctors have prescribed. Assess the patients’ capacity to complete dialysis sessions and take all drugs prescribed by their doctors.

Classic hemodialysis has many of its varieties. Extracorporeal dialysis methods also include hemofiltration and hemodiafiltration, which are increasingly used not only in acute renal failure (ONN) but also in chronic renal failure (PNN). (1 ,2 )

Hemodialysis vs Dialysis:

  1. Dialysis: Dialysis is a technique in which a machine that functions like an artificial kidney filters your blood.
  2. Hemodialysis: Your entire blood is circulated outside your body in a machine called a dialyzer that is put outside the body. This dialyzer cleans and returns blood to your body, similar to an artificial kidney. This can be done at a dialysis centre or at home. Hemodialysis is commonly referred to as dialysis, and there is no distinction between the two terms.

Read more.. Caring for Patient After Kidney Transplantation

Hemodialysis procedure step by step:

Most dialysis clinics demand that you have a trained partner at your home during hemodialysis treatments, so you’ll need to enlist the help of a family member or friend. A home-training nurse from the clinic will teach you important safety practices.

You and your caregiver partner will learn care for hemodialysis patients

  1. set up the machine.
  2. take steps to prevent infection .
  3. place needles into the vascular access.
  4. respond to any alarms from the machine.
  5. check your weight, temperature, heart attacks, strokes or eye damage.
  6. Omega-3 fatty acids : Omega-3 fatty acids improve cholesterol levels and lower blood pressure, and pulse.
  7. record treatment details for the clinic.
  8. clean the machine.
  9. throw out used supplies safely.

How do dialysis patients Die:

222 of the 532 individuals who started dialysis died. The six causes of death were classified as follows: cardiac, infectious, dialysis withdrawal, sudden, vascular, and “other.” Infections were the leading cause of mortality, followed by dialysis withdrawal, cardiac, sudden death, vascular, and other causes.

Dialysis side effects:

Low heart attacks, strokes or eye damage.

Omega-3 fatty acids : Omega-3 fatty acids improve cholesterol levels and lower blood pressure, access site infection, muscle cramps, itching skin, and blood clots are the most common hemodialysis side effects. Peritonitis, hernia, blood sugar abnormalities, potassium imbalances, and weight gain are the most prevalent peritoneal dialysis side effects.

Mental side effects of dialysis

Depression, anxiety, suicide, and delirium are all common consequences in renal failure patients. The psychiatrist must keep a close eye on the pharmacological management of these issues.

Dialysis and home hemodialysis comparison (care for hemodialysis patients at home)

Use the table below to decide whether you should have dialysis at a clinic or at home.

Dialysis Center and Home Hemodialysis Comparison Chart
Dialysis center Home
Schedule Three four-hour treatment are given three times a week. Tuesday, Thursday, and Saturday; or Monday, Wednesday, and Friday. Flexible. Three to seven short or long treatments per week at times that work best for you.
Availability Available in most communities; may require travel in some rural areas. Becoming more widely available as smaller equipment is developed.
Machine/supplies The clinic has the machine and supplies. The machine, as well as supplies for two to four weeks, are already in the house. To connect the machine to electricity and water, you may need to make modest alterations to your home.
Training Treatments, diet, drinks, drugs, lab tests, and other topics are covered at the clinic. Three to eight weeks of home care for hemodialysis patients training is required for you and a partner.
Diet and liquids Strict limits on liquids, phosphorus, sodium, and potassium intake. Fewer limits on liquids or diet, based on the amount of hemodialysis and lab tests.
Level of freedom Less freedom on treatment days. May feel washed out and tired for hours after each treatment. Because you set the treatment schedule to match the total amount prescribed, you have more freedom. Work and travel are a lot less difficult.
Amount of work Center staff members do hemodialysis tasks. They can teach you to do some tasks. You and your partner must set up, operate, and clean the machine, as well as monitor vital signs, log treatments and submit paperwork, and place orders for supplies.
Payment Three hemodialysis sessions per week are covered by Medicare and most other health plans. Other health plans may cover all hemodialysis treatments; Medicare covers three care for hemodialysis patients and treatments per week and may cover extra for medical reasons.

Hemofiltration (HF)

Care for a Hemodialysis patients

Hemofiltration (HF) is an extracorporeal procedure used in Hemodialysis patients, with chronic renal failure only in a continuous manner in the form of continuous arteriovenous or Veno venous hemofiltration (CTZH, CZZH). (3 , 4 , 5 )

Intermittent haemofiltration is used in Hemodialysis patients with acute renal failure. According to the definition, the procedure “involves the simultaneous removal of 40 – 70 l of plasma water together with dissolved organic and inorganic compounds (convection process) and reinfusion of an equivalent volume of sterile fluid with a properly selected composition.” (6 )

Dialysis education for patients:

Dialysis-related bloodstream infections are a serious complication. Hemodialysis is used by roughly 370,000 persons in the United States. These people are at danger of contracting life-threatening illnesses.

A total of 75,000 patients have hemodialysis via a central line. A central line is more likely to become infected than a fistula or graft. According to the CDC, 37,000 central line-associated bloodstream infections occurred in hemodialysis patients in the United States in 2008.

Physicians, nurses, dialysis technicians, and all other healthcare personnel must be aware of and adhere to rigorous infection control practices. The resources on this page are intended to assist dialysis clinicians in learning about infection control essentials.

Trusted Source: CDC/dialysis/clinician

When is dialysis not recommended

For some people with kidney failure, dialysis may not be the best option. Dialysis does not guarantee a survival benefit for persons over 75 who have medical conditions such as dementia or ischemic heart disease in addition to end-stage renal disease, according to several European studies about care for hemodialysis patients.

In fact, it frequently degrades their quality of life. According to one study, elderly persons who had dialysis lived a year longer on average than those who didn’t, but almost all of that extra time was spent in the hospital, commuting to and from dialysis, or receiving dialysis treatments.

Hemodiafiltration (HDF) dialysis

Hemodiafiltration (HDF) dialysis is a technique that has many benefits for Hemodialysis patients, being treated for chronic renal failure. (7 )

There are groups of patients for whom this procedure is particularly indicated. These are patients with concomitant circulatory diseases, hypertension, high body weight, and if they have contraindications for a permanent kidney transplant or the waiting period will be longer than 2 years.

Moreover, Hemodiafiltration gives many benefits to patients. It is hemodynamically stable, it has better anemia control and better fluid elimination. It also has a beneficial effect on lipid metabolism and generates less pro-inflammatory factors and cytokines during surgery.

Hemodiafiltration also has fewer side effects than other renal replacement therapy techniques. Hemodiafiltration is a convergence in which diffusion as in hemodialysis and convection as in hemofiltration are combined.

It is also used in the treatment of acute renal failure and can be used in the form of continuous methods as continuous arteriovenous hemodiafiltration and venous hemodiafiltration (CTZHDF, CZZHDF) (8 ).

Therapeutic plasmapheresis may also be used to treat chronic renal failure. Plasmapheresis is a procedure that removes plasma with a simultaneous exchange for fresh frozen plasma, multi-electrolyte fluid, a solution of human albumin using a specific filter.

  • Plasmaphereses remove soluble factors such as immune complexes, proinflammatory cytokines, autoantibodies that can damage the basal membrane of the glomeruli of the cell.
  • The glomerular hardening and stromal fibrosis are slowed down. Thus, kidney function is improved.
  • In nephrology, therapeutic plasmapheresis is mainly used for glomerulonephritis and renal transplant rejection. Information on hemofiltration, hemodiafiltration and therapeutic plasmapheresis come from the book “Diagnosis and treatment of kidney diseases – guidelines, recommendations, and standards of conduct”.

A patient with chronic renal failure must be prepared for hemodialysis long before it begins. The reason is the need for vascular access to effective care for hemodialysis patients. (9 )

  • Detailed information on vascular access comes from the book “Diagnosis and treatment of kidney disease – guidelines, recommendations, and standards of management”.
  • A fistula should be formed when creatinine clearance is & lt;25 mg/min.
  • This is because after producing a fistula, you should wait from one month to several in the case of a primary fistula and 6 weeks in cases of artificial fistula until it can be used for hemodialysis.
  • There are three types of fistulae used for hemodialysis. The first type that NKF DOQI is recommended is a primary fistula, made from the patient’s own vessels.
  • In the case of a primary fistula, they are produced radially – radially near the Hemodialysis patient’s wrist and at the height of the ulna using the brachial artery and arm veins.
  • It is recommended to start the fistula production as low as possible and to produce it in the elbow flexion as soon as possible. The patient’s vessels are saved in this way, which he may need in the future (10 ).
  • If the Hemodialysis patient cannot have a primary fistula from his own vessels, artificial polytetrafluoroethylene is used. In emergency cases, catheters inserted into large venous vessels are used for hemodialysis.
  • However, they cannot be used for more than 3 weeks because of the risk of infection that increases with time when the catheter is used.
  • When the catheter needs to be used for a longer period of time and a primary or artificial fistula cannot be produced, a permanent catheter is used (11 ).
  • However, they cannot be used for more than 3 weeks because of the risk of infection that increases with time when the catheter is used.
  • When the catheter needs to be used for a longer period of time and a primary or artificial fistula cannot be produced, a permanent catheter is used.
  • However, they cannot be used for more than 3 weeks because of the risk of infection that increases with time when the catheter is used.
  • When the catheter needs to be used for a longer period of time and a primary or artificial fistula cannot be produced, a permanent catheter is used.

It differs from other catheters in the material from which it is made and in the presence of a dacron cuff, which allows the catheter to grow into the subcutaneous tissue. A permanent catheter can be maintained for up to several years.

Complications after a fistula for hemodialysis and temporary catheters are divided into early and late. Information on complications and how to care for vascular access comes from the publication

Early complications after fistula include postoperative wound infections, edema on the limb with fistula, lack of blood flow in the fistula, which is manifested by lack of tinnitus, limb ischemia, and the presence of collateral circulation in the fistula. (12)

Late complications after fistula include primarily infections, aneurysms and pseudoaneurysms, and fistula clotting.

Early complications after establishing a temporary catheter for hemodialysis include pneumothorax, air embolism, pleural bleeding, pericardium, mediastinum after perforation of the subclavian vein or jugular vein or bleeding into the retroperitoneal spaces after puncture of the femoral vein.

Arrhythmias may also occur, and incorrect placement of the hemodialysis time catheter may cause that the blood supply will be inappropriate, thus endangering the Hemodialysis patients life.

Late complications of the temporary hemodialysis catheter are infection, atresia or thrombosis of the catheter as well as perforation of the vessel.

“Care for the catheter exit site involves changing the dressing around the catheter. It should be done daily and before each dialysis.

Because the skin around the catheter should be dry, it is recommended to change the dressing after each bath.

You can also apply ointments with antibacterial agents to the skin around the mouth of the catheter.”

 

  • The patient’s primary fistula care recommendations cover many issues. In the aspect to care of Hemodialysis patients should not bear weights over 3 kilograms in his hand with a fistula. He should also not sleep on the limb on which the fistula was formed and have his blood pressure measured.
  • The patient should be aware of possible complications and be able to recognize them. To this end, the condition of the fistula must be monitored. After completing dialysis, dressings can be removed at the earliest after 12 hours.
  • The patient is also not allowed to perform dressings that would inhibit blood flow in the limb on which the hemodialysis fistula was made.
  • Patient care during Hemodialysis consists primarily of constant monitoring of the patient’s state of health.
  • Information on patient care during dialysis comes from the publication “Renal replacement therapy in nursing practice”.
  • It is the nurse’s responsibility to record patient vital signs on the dialysis card at least once an hour. At least one nurse must be present at all times during the dialysis session. It is unacceptable to leave patients alone.
  • The nurse prepares and administers drugs and performs other medical procedures ordered by the doctor. He also provides first aid in the event of acute complications in Hemodialysis patients who are undergoing hemodialysis.
  • There are a variety of acute complications that can occur during hemodialysis. Among them, we distinguish hypotension and interdialytic hypertonia, itching of the skin, muscle cramps, and fever reactions.
  • Electrolyte disturbances such as hyperkaliemia and hypocalcemia may occur.

There may also always be an air embolism. If it occurs, discontinue dialysis, give the Hemodialysis patients oxygen and apply for the Trendelenburg position.

  1. Abdominal pain, shortness of breath, coronary pain, anxiety, and cold, wet skin may indicate the occurrence of hemolysis. In these cases, dialysis should also be interrupted, oxygen administered and the Hemodialysis patients monitored.
  2. Your first dialysis syndrome may occur during your first hemodialysis session. We divide this syndrome into anaphylactic and non-specific reactions.
  3. In the case of an anaphylactic reaction in the patient, we will observe, among others, symptoms such as a decrease in heart attacks, strokes or eye damage.Omega-3 fatty acids : Omega-3 fatty acids improve cholesterol levels and lower blood pressure, rapid shortness of breath, laryngeal edema, urticarial, abdominal pain, and anxiety.
  1. This case, hemodialysis should be discontinued, the Hemodialysis patients should be given oxygen for breathing, his condition should be monitored and medication prescribed
  2. In the case of a non-specific reaction, cough, slight itching, tightness of the chest, and pain in the sacrolumbar region may occur and in this case, there is no need to stop the procedure. It can be resumed after the patient has been given oxygen.
  3. Monitor his condition and give medicines according to a doctor’s order. In the case of a non-specific reaction, cough, slight itching, tightness of the chest, and pain in the Sacro lumbar region may occur and in this case, there is no need to stop the procedure. It can be resumed after the care of Hemodialysis patients have been given oxygen. monitor his condition and give medicines according to a doctor’s order.
  4. In addition in the case of a non-specific reaction, cough, slight itching, tightness of the chest, and pain in the Sacro lumbar region may occur and in this case, there is no need to stop the procedure.
  5. The patient’s heart attacks, strokes or eye damage.Omega-3 fatty acids : Omega-3 fatty acids improve cholesterol levels and lower blood pressure should also be monitored continuously. The patient may also develop dialysis hypoxemia, i.e. an increase in oxygen pressure.

Related Topic: Care for a Patient on Peritoneal Dialysis:

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Written by Dr. Ozair (CEO of SignSymptom.com) as physician writers are physicians who write creatively in fields outside their practice of medicine.

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