Hemodialysis and You

Process, Safety, and Diet - What you need to know

What is Hemodialysis?

When you have a diagnosis of Chronic Renal Failure and your kidneys can no longer filter the toxins out of your blood, this is when your doctor will bring up the need to start a process referred to as Dialysis. More specifically, Hemodialysis is the process of starting a line from one of your arteries, which will run blood from your body through a machine called dialyzer, which will clean your blood using a fluid called dialysate, which acts as a filter to collect toxins. After the blood has been cleaned by the dialysate, it is run out of the machine through different, clean tubing, and put back into your body through a vein. The sites where the blood comes out of your artery and returns to your vein are accessed just the same as when someone is receiving IV fluids. The dialyzer machine acts as a kidney outside of the body, and the artery and vein needed are accessed via a fistula made by your doctor. A fistula is a joining of an artery and vein in either your arm or your leg, and is done by simple surgery. Dialysis not only removes toxins, but also extra fluid, so it is important to maintain a healthy blood pressure, and levels of electrolytes such as potassium and sodium, for example.

Diabetes and High Blood Pressure are the two main causes of Chronic Renal Failure. Continuous high levels of blood sugar can cause damage to organs, such as the kidneys, and continuous high blood pressure damages blood vessels.
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How often do you need Dialysis?

The process of hemodialysis is life long for those with Chronic Renal Failure, as the kidneys do not recover with this diagnosis - unless you receive a kidney transplant. Hemodialysis needs to be done typically three times per week and generally lasts about three to five hours each time. This can vary depending on how much waste is in your blood, if you gain high or low amounts of fluid between treatments, and if your kidneys have any of their own function at all.

It is important to remember dialysis is to sustain healthy life, it is not a cure for kidney disease.

Dialysis Safety

Infection is the biggest risk with hemodialysis, symptoms of infection include redness, swelling, heat, pain and drainage. It is important to report any of these symptoms to your doctor immediately!
Clotting is another risk of hemodialysis, as a clot where access to blood vessels is needed can interfere with dialysis occurring and also cause dangerous changes in bodily fluids and electrolytes such as potassium, sodium and chloride.

It is important to remember that you cannot have blood draws, IV fluids, or blood pressure readings taken from the arm that has your fistula.

Follow the picture below for additional ways to keep your dialysis site healthy and prevent infection:
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Dialysis and Diet

Sticking to a diet that is based around your needs as a dialysis patient is the most important way to keep yourself healthy. It is important to eat to consume less sodium (salt), potassium, and phosphorus. It is also key to know the limits on your personal fluid intake.

Here's how you can do it:

Reducing salt / sodium -
will help with the amount of fluid your body holds onto between dialysis treatments, and help maintain a healthy blood pressure. Instead of adding salt to your foods for flavor, try adding herbs and spices or other options labeled as low sodium. It is important when reducing sodium that the replacements are not high in potassium! Also - avoid pre-packaged and processed foods.

Reducing potassium -
Potassium is an electrolyte that helps with muscle contractions, including your most important muscle - the heart.
Foods that should be avoided are bananas, dried fruit, raisins, kiwi's, melons, avocados, tomatoes, cooked spinach or asparagus, and beets.
Low potassium fruits and vegetables include grapes, peaches, pears, pineapple, carrots, cabbage, garlic, celery, onion and radishes. It is acceptable to have 2-3 servings of these low potassium foods daily.

Reducing phosphorus -
Dairy foods contain very high levels of phosphorus, so it is important to reduce the amount of dairy in your diet. Some alternatives are non-dairy whipped topping and sherbet, as well as brie and cream cheese.

Also, speak with your doctor about your personalized fluid plan and the importance of keeping track of the amounts you take in, holding onto fluid means holding onto electrolytes!

*With diabetes, it is important to remember to watch your carbohydrates and sugar in your diet as well, take insulin accordingly, and never skip meals*

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References

About Chronic Kidney Disease. (2014). Retrieved March 26, 2016, from https://www.kidney.org/kidneydisease/aboutckd


Dialysis. (2015). Retrieved March 26, 2016, from https://www.kidney.org/atoz/content/dialysisinfo



Dietary Guidelines for Adults Starting on Hemodialysis. (2015). Retrieved March 26, 2016, from https://www.kidney.org/atoz/content/dietary_hemodialysis


Garrick, R., Kliger, A., & Stefanchik, B. (n.d.). Patient and Facility Safety in Hemodialysis: Opportunities and Strategies to Develop a Culture of Safety. Retrieved March 26, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315342/

Pellico, L. H. (2013). Focus on adult health: Medical-Surgical Nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (Edition 1, pages 754-761)



(n.d.). Retrieved March 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022166/