Vous êtes sur la page 1sur 5

Predialysis Treatment Procedures

Before the dialysis treatment is carried out evaluating the patients health before a treatment to compare this information with data from past treatment in order detect abnormal findings this would be reported to a nurse who may then decide the nature of the patients health that is if the patient is stable or not stable to undergo and dialysis treatment. Factors measured before dialysis are weight, pulse, blood pressure, respiration, temperature and vascular access. If the patient weight reading is abnormal this is probably an indication that the patient has too much fluid and this is called a edema when the patient has a build up of fluid in their tissue.

Vascular access creates a way for blood to be removed from the body, circulate through the dialysis machine, and then return to the body at a rate that is higher than can be achieved through a normal vein. There are three major types of access: primary AV fistula, synthetic AV bridge graft, and central venous catheter. Other names for an access include a fistula or shunt. The access should be created before hemodialysis begins because it needs time to heal before it can be used. Discussions about the access should begin even earlier, since you will need to avoid injuring blood vessels that will eventually be used for access. Having an intravenous line (IV) or frequent blood draws in the arm that will be used for access can damage the veins, which could prevent them from being used for a hemodialysis access. The access is usually created in the non-dominant arm; for a right-handed person this would be their left arm.

Initiation of Dialysis
Once the predialysis tasks are done, the treatment can begin. A number of steps are needed to start the treatment: calculating how much fluid need to be removed from the patients blood which is totally dependent on the amount of weight loss is desired that is the estimated dry weight, venipuncture (putting the needles into the patients access), blood testing to determine the blood glucose sugar level, and starting the machine. Blood begins to cycle through the external tubing The pump does not directly contact the blood or fluid in the plumbing it works by applying pressure to the tubing, then moving that pressure point around. An average adult has between 10 to 12 pints of blood. Even though all systemic blood is filtered before the process ends, only one pint is outside the body at any given time. As the blood circulates through the system, the dialysis solution pulls the waste and fluid from the blood through the microscopic holes of a semi-permeable membrane filter. The blood goes back into the body after the filtering process. The dialysis machine constantly monitors blood flow, waste removal, pressure changes, temperature, dialysate mixture, toxins, clotting, leaks, and air trapping. Alarms ring when any of the above parameters falls out of specifications.

The side effects of heamodialysis

Most patients tolerate hemodialysis well. However, side effects of hemodialysis can occur. Low blood pressure is the most common complication and can be accompanied by lightheadedness, shortness of breath, abdominal cramps, muscle cramps, nausea, or vomiting. Treatments and preventive measures are available for the discomforts that can occur during dialysis. Many of these side effects are related to excess salt and fluid accumulation between dialysis treatments, which can be minimized by carefully monitoring how much salt and fluid you consume.

Amyloidosis Patients on hemodialysis for more than five years can become vulnerable to amyloidosis. Amyloidosis occurs because hemodialysis has not effectively removed a protein called beta-2microglobulin from the blood. Eventually, molecules of this protein start linking together and depositing on muscles and other tissues which may cause tears in ligaments and tendons half the people with dialysis related amyloidosis go on to develop carpal tunnel syndrome. Carpal tunnel syndrome is pressure on the median nerve -- the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers. Fluid overload Hemodialysis patients sometimes develop a condition called fluid overload between dialysis sessions. Excess water collects under the skin at the ankles and elsewhere in the body, including the lungs. To avoid fluid overload, hemodialysis patients should restrict the amount of fluid they drink. This also helps avoid the problems caused by rapid physical changes during hemodialysis. Restrictions on fluid intake for hemodialysis patients are stricter than those for peritoneal dialysis patients. Hyperkalemia Hyperkalemia is caused by too much potassium in the blood and can interfere with the heart's rhythm. Severe hyperkalamia can cause the heart to stop. Most hemodialysis patients are asked to restrict their intake of foods that contain a lot of potassium. Pain Pain may be a common side effect due to the vascular access being damaged on not being heal properly. Blood-borne viruses Some patients have concerns about contracting blood-borne viruses, such as hepatitis B or C, or HIV. All Dialysis centers take measures to protect patients from this risk. If you are concerned, you should discuss your concerns with the medical team.

Problems in the medical world

Fistulas Not all fistulas work perfectly. Some never develop into a vein that is large enough. Some work well for years and then suddenly stop. In either case, a new fistula (or sometimes a graft) will have to be made in another part of the body. Only a limited number of veins can be made into a fistula. Caring for the fistula is important.

Access can be a particular problem for patients with diabetes or for children since the blood vessels are often very narrow. HD catheters HD catheters may stop working because they become blocked by a blood clot. If this happens, they will have to be declotted or replaced. Only a limited number of veins are suitable for catheter insertion. Needles If access is achieved via a fistula or graft, it is necessary to insert needles at the start of each dialysis session. Even with a local anesthetic, some patients find this painful. Bleeding Some patients may have problems with bleeding from the fistula either during or after dialysis. There are now special bandages available which can help stop the bleeding more quickly. Most Dialysis centers can supply these or advise where they can be obtained.

Read more: http://www.livestrong.com/article/125607-kidney-dialysis-side-effects/#ixzz1gofypGPJ


In hermodialysis, infections occurs by directly accessing the veins and arteries in the arm via a surgically implanted fistula or graft.

Read more: http://www.livestrong.com/article/125607-kidney-dialysis-side-effects/#ixzz1goZ1hY2I

Read more: http://www.livestrong.com/article/114264-kidney-dialysis-process/#ixzz1goFMbdMJ

Read more: http://www.livestrong.com/article/114264-kidney-dialysis-process/#ixzz1goEPnftU

Read more: http://www.livestrong.com/article/114264-kidney-dialysis-process/#ixzz1goByuzkt