Also known as dialysis, hemodialysis is a treatment used for individuals whose kidneys have failed. A special machine is used to function as your kidneys, filtering waste products and purifying your blood.Monterey Bay Vascular is a vascular specialty facility that offers outpatient access to dialysis treatment and management. Our outpatient services specialize in minimally invasive procedures and use the latest ultra-modern imaging, interventional, and diagnostic technology. Our facilities and technologies allow us to meet the needs of dialysis patients providing them with comprehensive dialysis access management and care.
Causes of Renal disease damage or impair the kidney’s function over time if they are not addressed early. Some of the diseases and conditions for the renal disease include;
Because of the highly adaptable nature of the kidneys, they can easily compensate for the early loss in function. This factor means you may observe symptoms when significant damage has already occurred. The symptoms are also mostly non-specific and could be caused by other illnesses, which means you can miss out on early detection of kidney disease.
As the disease progresses, you may observe the following symptoms
Like any other medical treatment option, hemodialysis comes with certain risks. First, it is important to realize that while it does prolong many people’s lives, patients who need it have a generally lower life expectancy than the general population. In the course of your treatment, you could also experience several related complications though not everyone experiences all of them.
Low blood pressure is a common side effect for patients using hemodialysis and more so among patients with diabetes. It is often accompanied by abdominal cramps, nausea, muscle cramps, and shortness of breath.
Muscle cramps: These are also common in the course of hemodialysis treatment though their cause is not quite clear. Fortunately, they can be alleviated by making adjustments to the hemodialysis prescription and the intake of fluids and sodium in between treatments.
Itching: You can experience itching that gets worse during the procedure or just after the hemodialysis procedure.
Difficulty sleeping: Hemodialysis patients have sleeping problems because of issues like sleep apnea, itching, uncomfortable and restless legs.
Anemia: Failing kidneys reduces erythropoietin, a hormone responsible for stimulating red blood cell formation. Further, the diet restrictions, removal of vitamins and iron through hemodialysis, frequent blood tests, and poor iron absorption contribute to anemia.
Bone diseases: Because of kidney failure, your body cannot process Vitamin D, which affects its ability to absorb calcium as thus, the bones weaken. Also, the failing kidneys cause an overproduction of the parathyroid hormone, which can cause the bones to release calcium.
High blood pressure: If you take plenty of fluids and consume a lot of water, your blood pressure is likely to worsen, which can cause cardiovascular complications.
Fluid overload: Hemodialysis focuses on getting rid of fluids from the body. As a result, if you consume a lot of fluids, you may end up developing complications like pulmonary edema, where fluid accumulates in the lungs. It can also cause heart complications.
Pericarditis: This is a condition where the membrane surrounding the heart becomes inflamed. It happens as a result of insufficient hemodialysis, which affects the heart’s ability to pump blood.
Hyperkalaemia: This refers to a condition where there are high potassium levels in the blood. Kidneys usually excrete potassium, but if you are using hemodialysis, you have to control the amount you consume since high potassium levels could cause heart complications.
Complications on the access site: without proper care, the access site can become vulnerable to complications like infections, blockage, or aneurysms, affecting the quality and safety of your hemodialysis. Your care team from Monterey Bay Vascular will show you how to best care for the site and how to be on the lookout for any signs of a problem.
Amyloidosis: This condition happens when blood proteins are deposited on joints and tendons. It results in stiffness, fluid, and pain in the joints. People who have been using hemodialysis for more than five years are more susceptible to this condition.
Depression: Mood swings are common among kidney failure patients, which could lead to anxiety and depression. If you experience any of these conditions after you start your hemodialysis treatment, our staff will be on hand to guide you on the best treatment and coping options.
Some of the conditions which may cause kidney failure include:
Kidneys are responsible for removing excess fluids and wastes from your blood and, in doing so, purifying it. However, when the kidneys are not functioning properly, you have to resort to dialysis. This is a treatment where a machine does the filtering and purification function of your kidneys.
The doctors will take several health records before the procedure, including weight, temperature, pulse rate, and blood pressure. They will also clean the skin surface of the access point.
The doctors insert two needles through the access site and secure them by taping. Each needle connects to the dialyzer through a flexible plastic tube. In one tube, blood passes from your body to the dialyzer, where it is filtered through a cleansing fluid (dialysate), where wastes and extra fluids are removed. Through another tube, the clean blood flows back to your body.
Normally, you could experience symptoms such as abdominal cramps and nausea as the excess fluids are removed from your body. These symptoms can be more intense if you only do hemodialysis three times a week and not the frequent shorter sessions. Should you be uncomfortable, inform our care team, who will help minimize them through adjusting your medication or the fluids and speed of the procedure.
In the course of your treatment, your heart and blood pressure will fluctuate, and therefore the healthcare professionals will constantly check on you during each treatment.
At the end of the treatment, the doctor removes the needle and uses pressure dressing on the access site to prevent any bleeding. Your weight is recorded again, and you are free to continue with your daily activities.
One of the latest developments in this field of medicine is the introduction of the EndoAVF, which stands for the Endovascular Creation of an Arteriovenous Fistula. Here’s a simplified but thorough look at some of the key elements you might like to know when it comes to this procedure, including what to expect as a potential client of the vascular experts at Monterey Bay Vascular.
Fistula creation starts with Vein Mapping, where you undergo physical examination along with non-invasive or minimally invasive tests. These tests determine whether your arteries are sufficiently healthy to support a fistula. Ultrasound and an angiogram can also be used to gauge the size and depth of your veins and arteries. If you pass the tests and are judged to be a candidate for fistula, then an appointment is made for fistula creation.
The actual process starts with a specialist administering local anesthesia on the identified access site. A doctor then makes an incision that provides access to the blood vessels, and he makes a surgical connection between a vein and an artery. As a result of the connection, blood flows from the artery to the vein, and with this increase in blood flow, the vein enlarges, and its walls thicken.
After its creation, the AV fistula is given weeks to months in some cases to mature to the point where it can be used safely for hemodialysis.
This is a temporal option for hemodialysis, where HD catheters serve as temporal access points. They provide direct access to the bloodstream and have a high infection rate, which is why their use as a temporal solution. The idea is for the patient to eventually have long-term safer access like AV fistula or a peritoneal catheter. The catheters have heparin to help prevent blood clotting while flowing in the tubes though they have to be changed for new ones as a further precaution. HD catheters only serve when one is yet to have permanent access or where the permanent access is being rested or has stopped working.
This is a more permanent option, and it is a minimally invasive procedure that can be conducted in an outside setting. In this procedure, a PD catheter is placed in the peritoneal space through the abdomen. The specialist uses an image-guided technique known as fluoroscopy to achieve the Percutaneous catheter placement. It usually takes less than an hour to complete, and you only need sedation and local anesthesia.
Your access point needs consistent care to prevent any infection and blockage. Some of the services we provide as care for the access points are:
Preparing for hemodialysis takes anywhere from weeks to months before your first treatment. Part of the preparation plan is to create vascular access, which provides easy access to the bloodstream. Through it, a small amount of blood can be removed and returned from and to your blood circulation safely. Once it has been created, it will need time to heal before you start the treatment.
It is essential that you, as a patient, care for your access site to prevent any complications and infections. Our team will provide you with the guidelines for proper access site care, and you should follow them diligently.
Dialysis is provided at a hospital, dialysis centers, or from your home. How often you receive it depends on your situation. For example, if you have in-center hemodialysis, you will often need your treatment three times a week in sessions that last 3-5 hours each.
There is also an option of daily hemodialysis, which involves shorter but frequent sessions. It is often conducted at home and six or seven days every week, lasting 2-3 hours.
The innovation of simpler dialysis kits has made home hemodialysis more accessible and convenient. With the proper training and a person to help, you can safely do hemodialysis at home. You could even do it during the night as you sleep.
Dialysis services are readily available across the US and in countries worldwide, so you can travel and still get your treatment on schedule. You can have your hemodialysis center contact and make appointments with other centers, or you can do it on your own. If you are traveling, you should make plans well in advance to guarantee space and ensure all arrangements have been made.
If your condition were a sudden kidney injury, you would need hemodialysis for only a short period until your kidneys get back to their optimum functioning levels. On the other hand, if your kidneys had already started dropping their functioning levels before the sudden injury, chances of complete recovery and hemodialysis independence reduce.
While in-center treatments are more common, outpatient home settings are increasingly preferred as more research shows their benefits. These benefits include;
Your assigned care team will regularly monitor your progress and the impact of the treatment through regular tests, including;
These results will guide any changes to your treatment frequency and intensity.
It is essential to take care of yourself and follow the doctor’s guidelines in between hemodialysis procedures. Doing so helps prevent any complications and helps you to attain the best possible results from your treatment. Some of the care tips to follow include;