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Haemodialysis Provision and Support

HAEMODIALYSIS PROVISION AND SUPPORT

Hemodialysis is a treatment method used for individuals with kidney failure or end-stage renal disease (ESRD). It is a life-saving procedure that helps remove waste products, excess fluid (water), and toxins from the blood when the kidneys are no longer able to perform their filtration function adequately.

Here's an overview of hemodialysis in kidney failure:
ACCESS CREATION

To perform hemodialysis, a vascular access site needs to be created, allowing the patient’s blood to flow through a dialysis machine to purify and cleanse the blood. This can be done through a fistula, where an artery and a vein are surgically connected, allowing for increased blood flow. Alternatively, a graft, which is a synthetic tube, can be placed to connect an artery and a vein. Another option is a central venous catheter, which is a temporary tube placed in a large vein, usually in the neck or chest.

DIALYSIS MACHINE

During hemodialysis, the patient's blood is circulated through a dialysis machine. The machine consists of a special filter called a dialyser. The dialyser contains a semipermeable membrane that allows waste products, toxins, and excess fluid to be removed from the blood.

BLOOD CLEANSING

Blood is pumped from the patient's access site into the dialyser, where it passes through the membrane. On the other side of the membrane, a dialysate solution, which contains electrolytes and other substances, helps remove waste and excess fluid from the blood. The cleaned blood is then returned to the patient's body.

DURATION AND FREQUENCY

Hemodialysis is typically performed 3 times a week, with each session lasting about 4 hours. However, the specific duration and frequency of hemodialysis may vary based on the individual's needs and their healthcare provider's recommendations.

TYPES OF HEMODIALYSIS

The Nephrologist (kidney specialist) has several types of Hemodialysis that can be prescribed for a patient, based on their needs.  These include a gentler incremental hemodialysis, nocturnal hemodialysis which can be done at night while the patient can sleep, hemodiafiltration which can be useful in patients with large amounts of fluid overload or weak heart condition, etc.

INFORMED CONSENT

Participation in an Early Access Program involving investigational treatments, requires the patient's informed consent. Patients must be provided with comprehensive information about the treatment, including its potential risks, benefits, uncertainties, and alternatives. The patient has the right to make an informed decision regarding their participation and can withdraw from the program at any time.  For therapeutics involving expensive medications, appropriate counselling is provided to the patient regarding sustainability of the program and funding available.

BENEFITS OF HEMODIALYSIS

Removal of Waste Products

Hemodialysis helps remove waste products such as urea, creatinine, uremic toxins and excess electrolytes from the blood, improving overall body functioning.

Fluid Balance

It helps regulate fluid balance by removing excess fluid that may accumulate in the body due to impaired kidney function.

Electrolyte Balance

Hemodialysis helps maintain proper electrolyte balance in the body by removing excess or toxic levels of electrolytes such as potassium, sodium, calcium and phosphate.

Blood Pressure Control

It can help control blood pressure in individuals with hypertension related to kidney failure.

Symptom Relief

Hemodialysis can alleviate symptoms such as fatigue, nausea, and shortness of breath that may occur due to kidney failure.

PATIENT CONSIDERATIONS:

Lifestyle Changes

Hemodialysis requires regular visits to a dialysis centre and adherence to a strict treatment schedule as prescribed under the care of a Nephrologist (kidney specialist). It may involve dietary restrictions, fluid intake limitations, and medication management.  Without such patient compliance, the treatment’s value and beneficial outcomes can be reduced.

Vascular Access Care

Proper care of the vascular access site is crucial to prevent infections and complications. Regular monitoring and follow-up with a healthcare provider are necessary.

Potential Complications

Hemodialysis may be associated with certain risks, including infection, blood clotting, low blood pressure, muscle cramps, and access site complications. However, these risks can be minimised with proper medical care and adherence to treatment guidelines.

It's important for individuals with kidney failure to work closely with their healthcare team to determine the most appropriate treatment plan, including the type and frequency of dialysis, based on their specific condition and medical history.

At RHS, we provide comprehensive Clinical Governance programs for Hemodialysis with our team of specialists that have decades of experience and expertise.  RHS has a model of collaboration where the provision of such quality and evidence-based dialysis care is done at either RHS facilities or those of our dialysis-provision partners.  Please contact us for further information on how to enrol in such programs if you have kidney failure.
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