Haemodialysis – Procedure, Advantages and Disadvantages

If your kidneys have failed, Haemodialysis is a method of replacing some of your kidney’s functions by filtering and cleaning your blood using a machine. Our kidneys have a particular function, i.e., to filter and remove waste products and excess fluid from our blood. This article covers the definition, the process of Haemodialysis and much more. To learn more about Haemodialysis, scroll down the article.

What is Haemodialysis?

Haemodialysis is a medical procedure or method which is used to remove fluid and waste products from the blood and to correct electrolyte imbalances. Haemodialysis helps in controlling blood pressure and also allows us to feel better and live longer but this is not a cure for any kidney failure.

Fig: Haemodialysis

Haemodialysis is primarily used to treat acute and chronic renal failure that has failed to respond to traditional medical treatment. Acute intoxications (e.g., ethylene glycol poisoning) and preoperative conditioning of kidney transplant patients are two more applications.

Haemodialysis Machine

Fig: Haemodialysis Machine

What is the Process of Haemodialysis?

1. Kidneys are essential organs for life. Kidney activity is reduced by a variety of causes, including infections, damage, and limited blood supply to the kidneys. This causes a build-up of toxic wastes in the body, which can lead to a patient’s death.
2. During Haemodialysis, the patient’s blood goes through a filter, known as a dialyzer, outside the patient’s body.
3. A dialyzer is also referred to or called an “artificial kidney.” An artificial kidney is a device to remove nitrogenous waste products from the blood through dialysis. In case of kidney failure, an artificial kidney can be used.
4. Artificial kidneys are made up of a series of semi-permeable tubes suspended in a tank of dialysing fluid.
5. Except for the absence of nitrogenous wastes, this fluid has the same osmotic pressure as blood. The blood of the patient is pumped through these tubes.
6. The waste materials from the patient’s blood diffuse into the dialysing fluid during this passage.
7. The purified blood is reintroduced or pumped back into the patient body. This function is comparable to that of the kidney, but it differs in that it does not require reabsorption.
8. In a healthy adult, the first filtrate produced by the kidneys is around \(180\) litres per day. The leftover filtrate is reabsorbed in the renal tubules, so the volume actually expelled is just a litre or two each day.

Fig: Haemodialysis Process

How does the Dialyzer Clean the Blood?

1. The dialyzer, or filter, is composed of two parts: one for the patient’s blood and one for washing fluid known as dialysate. These two parts or components are separated by a thin membrane.
2. Blood cells, protein and other important things remain in the patient’s blood because they are not small and are too big to pass through the membrane.
3. Smaller waste products in the blood, like urea, potassium, creatinine and extra fluid pass through the membrane and are washed away.

Fig: Haemodialysis Process in the Filters

Where is Haemodialysis Done?

1. Haemodialysis can be done in a hospital or in a dialysis centre that is not part of a hospital or at home. At these places, health care professionals set up and help the patient to connect to the dialysis machine.
2. In these places, a team of health care workers will be present to help the patient. The patient will continue to see his/her doctors.
3. Other team members also will be present and may include healthcare-related persons, a dietician and a social worker.
4. In a dialysis centre, Haemodialysis is usually done \(3\) times per week for about \(4\) hours at a time. People who choose to do Haemodialysis at home may do dialysis treatment more frequently, \(4-7\) times per week, for shorter hours each time.

Diet During Haemodialysis

1. Diet plays a major role in haemodialysis patients. Dialysis patients are recommended to increase their protein intake while limiting their consumption of phosphorus, potassium, sodium, and other fluids.
2. Dietary restrictions may be imposed on patients with diabetes or other medical problems. It is important to talk with their dietitian about their individual nutritional needs.

Can Dialysis Cure Kidney Disease?

1. Dialysis may only be required for a short time in some situations of abrupt or acute renal failure until the kidneys recover.
2. When chronic kidney disease advances to kidney failure, the kidneys do not improve over time, and the individual will require dialysis for the rest of his or her life unless a kidney donation is available.

What are Possible Problems with Haemodialysis?

Some of the possible problems are as follows:
i. Muscle cramps are usually seen in dialysis patients.
ii. Itchy skin, which is frequently worse before or after a procedure.
iii. Low blood pressure, especially in diabetic patients.
iv. Fluid overload, which requires patients to ingest a certain quantity of fluid each day.
v. Infections or ballooning at the dialysis access site.
vi. Depressions and mood fluctuations.
vii. Intradialytic hypotension leads to poor long-term outcomes due to increased mortality and a higher likelihood of myocardial stunning (regional wall motion abnormalities during dialysis).
viii. Dialysis Disequilibrium Syndrome is more common in patients receiving their first dialysis treatment or shortly afterwards. It’s a clinical syndrome marked by neurologic degeneration, restlessness, mental confusion or uncertainty, and other symptoms.

Advantages of Haemodialysis

Some of the advantages of Haemodialysis are as follows:
I. Hemodialysis requires very little time compared to peritoneal dialysis.
II. Hemodialysis carries a relatively low risk of infection in individuals.
III. Hemodialysis requires fewer surgical procedures.
IV. The nurses perform treatments for the patients.
V. Contact with other hemodialysis patients and staff on a regular basis.

Disadvantages of Haemodialysis

Some of the disadvantages of Haemodialysis are as follows:
I. A patient may need to travel to a dialysis centre three times a week.
II. The patients may not be able to fix their own treatment schedule.
III. To get access to a fistula, needles are required.
IV. A strict renal diet and hydration restrictions are necessary.
V. Some patients report discomforts such as headaches, nausea, leg cramps, fatigue, and weakness as a result of the access sites.

Kidney Transplants vs Dialysis

Kidney transplantation is considered the treatment of choice for many people with severe chronic kidney disease because the quality of life and life expectancy are often better than in people who are treated with dialysis. However, there are several disadvantages to kidney transplants, including:
1. The kidney of donors won’t have the same antigens on cell surfaces, so there is a chance of rejection though the risk of rejection is reduced by ’tissue typing’ the donor and the recipient first.
2. The patient has to take immunosuppressant drugs for the rest of their lives which can have long term side effects and leave the patient vulnerable to infections, and they are expensive as well.
3. The risks of the surgery include infection, bleeding, and damage to the surrounding organs, and the patient has to be monitored regularly for infection.
But if a closely matched kidney is available, then it has some benefits over dialysis that  include:
1. The patient has much moredom due to not being bound to dialysis schedules.
2. Fewer dietary restrictions.
3. The use of dialysis machines is very expensive, and so this cost is removed due to transplantation.
4. A kidney transplant is a long-term solution with better quality of life, whereas dialysis will only work for a limited time.

Summary

Healthy kidneys clean our blood and remove extra fluid in the form of urine. They also make substances that keep our bodies healthy. Haemodialysis is one of the dialysis processes which involves diverting the blood through an artificial kidney machine that cleans and returns it to the body. Kidney disease is a serious condition. In people with chronic kidney failure, the kidneys are unlikely to recover, but dialysis can enhance wellbeing and prolong life for up to \(20\) years or more. Hence, we need to take care of our health and should always drink a good amount of water and should take all the precautionary measures to avoid these kinds of problems.

FAQs

Q.1. What is a haemodialysis machine?
Ans: It is a machine used in the dialysis process that filters a patient’s blood to remove excess water and waste products when the kidneys are damaged or dysfunctional. The dialysis machine is also known as an artificial kidney.

Q.2. What are the negative effects of dialysis?
Ans: The negative effects of dialysis are low blood pressure, muscle cramps, depressions, mood fluctuations, itchy skin, etc.

Q.3. Can kidneys start working again after dialysis?
Ans: The kidneys usually start working again within several weeks to months after the underlying cause has been treated. Dialysis is needed until then.

Q.4. When is Haemodialysis used?
Ans: When the kidneys no longer remove enough wastes and fluid from your blood to keep the patient healthy, then Haemodialysis is carried out.

Q.5. What is the difference between dialysis and Haemodialysis?
Ans: Dialysis is a procedure that helps the patient’s blood gets filtered by a machine that works like an artificial kidney. In Haemodialysis, the patient’s entire blood is circulated outside his/her body in a machine placed outside the body known as a dialyzer.

We hope this detailed article on Haemodialysis helps you in your preparation. If you get stuck do let us know in the comments section below and we will get back to you at the earliest.