Haemodialysis is a way of cleansing the blood of toxins, extra salt and fluids through a dialysis machine. It helps maintain proper chemical balance such as potassium, sodium and chloride and keeps blood pressure under control.

How does it work?

Dialysis is done using two needles which will be inserted into the vascular access, one to remove the blood and the other to return cleansed blood to the body. The patient is connected (via tubing) to the dialysis machine through a vein in the arm, the blood is pumped from the body to a special filter called the dialyser, which is made of tiny capillaries.

Blood is continuously pumped through the dialyser, where waste products and excess water are removed. The blood becomes purified when the waste products diffuse from the blood across the membrane of these tiny capillaries. This purified blood is then returned to the patient’s body through larger tubes.

Haemodialysis is performed as per the recommendation of treating doctor, with each session lasting about 4 hours, depending on the body size and medical condition.

Precautions

Before and during dialysis, the patients need to clean the skin covering the access before inserting the needles to avoid infection. Inform the nurse immediately if any signs of infection are noticed. The patients need to make sure that their blood is flowing and not clotting while on treatment. It is important that the catheter is kept dry, even when taking a bath.

The patients will also need to take care of their fistula or graft. They should not wear anything tight around the fistula/graft arm i.e. watches, bracelets, tight clothing, or carry heavy bags looped over the fistula/graft. Besides checking that the fistula/graft is working by feeling for the buzzing sensation every morning and night, the patients should not allow non-dialysis staff to take blood or blood pressure on their fistula/graft arm. They need to observe for signs of infection, such as redness, oozing of blood or pus, swelling and heat, and contact the nurse immediately if there are any problems with their fistula/graft.

How do take care of my fistula

There are important guidelines you must follow:

• Do not allow your blood pressure to be measured on your fistula arm

• Do not allow blood to be drawn or a drip installed in the fistula arm

• Do not wear a watch or tight clothing with elastic or restrictive bands on the fistula arm

• Do not sleep on top of the fistula arm

• Be careful when using any sharp object or equipment

With proper care and attention a fistula can last for many years and is one of the safest forms of access.