Best Care For Best Outcome

Archive for March, 2009

Hemodialysis Treatments

The time needed for your dialysis treatments depends on:

  • how well your kidneys work
  • how much fluid weight you gain between treatments
  • how much waste you have in your body
  • how big you are
  • the type of artificial kidney used

In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special filter (dialyzer) that removes wastes and extra fluids. The clean blood is then returned to your body. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals like potassium and sodium in your body. One of the biggest adjustments you must make when you start hemodialysis treatments is following a strict schedule.

Most patients go to a dialysis center— three times a week for four hours each visit. For example, you may be on a Saturday – Monday – Wednesday schedule or a Sunday – Tuesday – Thursday schedule. You may be asked to choose a morning, afternoon, or evening shift, depending on availability and capacity at the dialysis unit. Your dialysis center will explain your options for scheduling regular treatments.

Venous Catheter

A catheter is a tube inserted into a vein in your neck, chest, or leg near the groin. It has two chambers to allow a two-way flow of blood. Once a catheter is placed, needle insertion is not necessary.

Catheters are not ideal for permanent access. They can clog, become infected, and cause narrowing of the veins in which they are placed. But if you need to start hemodialysis immediately, a catheter will work for several weeks or months while your permanent access develops.

Arteriovenous Grafts

AV (arteriovenous) grafts are much like fistulas in most respects, except that an artificial vessel is used to join the artery and vein. The graft usually is made of a synthetic material, often PTFE, but sometimes chemically treated, sterilized veins from animals are used. Grafts are inserted when the patient’s native vasculature does not permit a fistula. They mature faster than fistulas, and may be ready for use several weeks after formation (some newer grafts may be used even sooner).

However, AV grafts are at high risk to develop narrowing, especially in the vein just downstream from where the graft has been sewn to the vein. Narrowing often leads to clotting or thrombosis. As foreign material, they are at greater risk for becoming infected. More options for sites to place a graft are available, because the graft can be made quite long. Thus a graft can be placed in the thigh or even the neck (the ‘necklace graft’).

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