In-Centre (Hospital) Hemodialysis
Hemodialysis is when blood is cleaned outside of the body using a machine and artificial kidney filter.
In-centre hemodialysis is usually done three times a week in a dialysis unit. There are 20 dialysis units across Manitoba. Nurses connect patients onto a hemodialysis machine and patients receive treatment for about four hours. This may be in the morning, afternoon or evening.
How a Hemodialysis Machine Works
Blood is pulled out of the body through a vascular access. A vascular access is created to be able to access the blood in the body. The blood then runs through a tube into the machine which houses a dialyzer and a special fluid solution.
The dialyzer is a circular tube filled with hundreds and hundreds of tiny hollow “strings”. Each of these strings are like a straw. Along the sides of the straw are even smaller holes, or pores, which allow the patients’ wastes to be filtered out. Blood passes through the inside of these straws. On the outside of the straws is fluid. The fluid (bath) is made specifically for each patient. The bath is what draws, or pulls, the waste products away from the blood. It is this action that cleans the blood.
The blood is then returned to the body through a different tube and the process happens continuously for about four hours.
What is Vascular Access?
Blood is pulled away from the patient and returned to the patient at a very fast rate. In order to accomplish this, a vascular access is required. Vascular accesses are created by physicians, most often vascular surgeons.
The different types of vascular accesses are:
Fistulas: created surgically by attaching an artery directly to a vein. The artery then enlarges the vein so that needles can be placed in the vein
Grafts: created surgically by attaching an artery to a vein using a piece of specially created tubing under the skin. The tubing portion is where needles are usually placed for each treatment
Central Venous Catheters: a soft type of tubing that is inserted directly into the patients’ blood stream. This tubing stays in place from treatment to treatment. Once inserted, no further needles are needed to provide hemodialysis treatment
Each patient will have one spot, or site that will pull the “dirty” blood, or blood with higher amounts of waste products, away and another site that will return the blood once it has been cleaned, or passed through the dialyzer.
Your weight, blood pressure and temperature are taken before and after treatment. Skin around your access site with be cleaned with antiseptic. During treatment your nurse will regularly check in with you. If you experience any unusual feelings during or after treatment, such as lightheadedness, headache, dizziness, nausea, blurred vision, loss of hearing or leg cramps, notify your nurse immediately.