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Chronic kidney disease and
acute kidney injury (also known as acute renal failure) cause the kidneys to lose their
ability to filter and remove waste and extra fluid from the body.
Hemodialysis is a process that uses a man-made
membrane (dialyzer) to:
For hemodialysis, you are connected to a filter (dialyzer)
by tubes attached to your blood vessels. Your blood is slowly pumped from your
body into the dialyzer, where waste products and extra fluid are removed. The
filtered blood is then pumped back into your body.
different types of hemodialysis. Talk about these with your doctor to decide
which one might be best for you.
Before treatments can begin, your doctor will need to
create a site where the blood can flow in and out of your body during the
dialysis sessions. This is called the
dialysis access. The type of dialysis access you have
will depend in part on how quickly you need to begin hemodialysis.
There are different types of access for hemodialysis:
Hemodialysis for acute kidney injury may be done daily
until kidney function returns.
About once a month, you will have blood tests to make
sure you are getting the right amount of hemodialysis. These tests are done to
help find out how well hemodialysis is working. Your weight before and after
each session will be recorded, as will the length of time it takes to complete
the dialysis session. If you have hemodialysis at home, you will need to keep
records of your weight before and after each session and the length of each
Hemodialysis is often started after
symptoms or complications of
kidney failure develop. Symptoms or complications may
Hemodialysis is sometimes used when acute kidney injury develops. Dialysis is always used with extra caution in people who have
acute kidney injury, because dialysis can sometimes cause low blood pressure,
irregular heart rhythms (arrhythmias), and other problems that can make acute
kidney injury worse.
Hemodialysis may improve your
quality of life and increase your life expectancy. But hemodialysis provides
only about 10% of normal kidney function. It does not reverse chronic kidney
Dialysis has not been
shown to reverse or shorten the course of acute kidney injury. But it may be
used when fluid and electrolyte problems are causing severe symptoms or other
problems. Some people who develop acute kidney injury stay dependent on
hemodialysis and will go on to develop kidney failure.
Most complications that occur during dialysis
can be prevented or easily managed if you are monitored carefully during each
dialysis session. Possible complications may include:
Long-term complications of dialysis may include:
Choosing between treatment with
hemodialysis or peritoneal dialysis is based on your
lifestyle, other medical conditions, and body size and shape. Talk to your
doctor about which type would be best for you.
If you have severe
chronic kidney disease and you have not yet developed kidney failure, talk with
your doctor about which type of dialysis might work best for you.
People who have widely fluctuating blood pressure when they receive
hemodialysis (hemodynamic instability) may not be able to continue with
treatment. They may be switched to
Many people first
receive dialysis while waiting for a kidney transplant. Some people may have to
receive dialysis again if the kidney transplant fails.
Complete the special treatment information form (PDF)special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
August 29, 2013
Anne C. Poinier, MD - Internal Medicine & Tushar J. Vachharajani, MD, FASN, FACP - Nephrology
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