Ⅰ. What is hemodialysis?
Hemodialysis (HD), also known as an "artificial kidney," is one of the main treatments for renal failure. It involves draining blood from the body outside the body through a dialyzer composed of countless hollow fibers. Through diffusion and convection, the dialyzer exchanges substances, removing metabolic waste and harmful substances from the body, maintaining electrolyte and acid-base balance, and removing excess water. The purified blood is then returned to the body. This entire process is called hemodialysis.
Ⅱ. What are the indications for hemodialysis?
1. Acute kidney injury; 2. End-stage renal disease; 3. Drug or toxin poisoning; 4. Severe fluid, electrolyte, and acid-base imbalances, such as difficult-to-correct hyperkalemia and hyperphosphatemia; 5. Acute heart failure due to volume overload or hypertension that is difficult to control with medication.
Ⅲ. Where should hemodialysis be performed?
Most patients choose to undergo hemodialysis at a reputable hospital's blood purification center, typically at least three times a week, with each treatment typically lasting four hours. Before starting hemodialysis, patients undergo surgical preparation, primarily to establish a vascular access system, which is the pathway for blood to leave and return to the body.
Currently, there are three different types of access systems:
1. Autologous arteriovenous fistula-the most common type of access system;
2. Central venous catheter (available in both temporary and long-term configurations);
3. Transplanted vascular fistula.
Ⅳ. What precautions should be taken during hemodialysis?
1.Fluid intake: Adjust your water intake based on urine output and dialysis dehydration, avoiding excessive drinking that can put strain on your heart.
2.Medication management: Strictly follow your doctor's instructions for medications and avoid arbitrarily increasing or decreasing the dosage or changing medications. Some medications are removed by dialysis, so regular dosage adjustments are required. Inform your doctor promptly of any side effects.
3.Dietary control: Develop a diet plan tailored to your medical condition and nutritional needs, ensuring adequate protein, calories, and vitamins. Limit sodium, potassium, and phosphorus intake, and avoid foods high in salt, fat, and sugar to prevent complications.
4.Maintain a healthy lifestyle: Maintain a regular sleep schedule, get enough sleep, avoid staying up late, and avoid overexertion. Exercises such as walking and Tai Chi can help strengthen your body and improve your quality of life.
5.Emotional regulation: Learn to regulate your emotions and maintain a positive attitude. Participate in social activities, connect with family and friends, and seek professional psychological counseling if necessary.
6.Regular checkups: Regularly check blood pressure, blood sugar, blood lipids, and kidney function to assess the patient's condition and treatment effectiveness, and adjust the treatment plan promptly. Monitor vital signs such as heart rate and blood pressure during dialysis, and notify the doctor promptly of any abnormalities.
7.Infection prevention: Maintain personal hygiene, wash hands, change clothes, and bathe frequently, and avoid contact with patients with colds or fevers. Clean and disinfect the dialyzer and vascular access during dialysis to reduce the risk of infection.
8.Vascular access care: Regularly check the vascular access and seek medical attention promptly if redness, swelling, pain, or bleeding occur. Avoid scratching or bumping the vascular access at home to prevent damage.
9.Family support: Family members should provide care and support, understand the patient's condition and treatment needs, provide daily care and psychological comfort, and make appropriate adjustments.