Imagine a world where you are no longer a slave of your kidneys and can live without having to worry about fatigue, diet, and edema in your legs. It would be like a dream come true to many. The good news is that you can experience it all when you undergo hemodialysis. 

It is a medical procedure that relies on a specially designed machine that passes the blood through a filter and removes the waste products, toxins, and excess fluids. But how does it work? How can a machine perform the work of an organ so complex? 

In this article, we answer all the questions that people often ask about hemodialysis. 

  • What is hemodialysis? 
  • What are the types of hemodialysis? 
  • How does hemodialysis work?
  • How long will each hemodialysis treatment last?
  • Can hemodialysis be done daily?
  • Is hemodialysis expensive?
  • Do I need to eat a special diet?
  • Can dialysis cure my kidney?
  • Will I be uncomfortable in hemodialysis? 
  • Can hemodialysis cause anemia?

What is hemodialysis?

When the kidneys are unable to effectively filter waste products, excess fluid, and toxins from the bloodstream, hemodialysis steps in as a formidable ally. 

Hemodialysis is a life-sustaining procedure that was designed for filtering waste from the blood for people suffering from end-stage renal disease to filter. 

It acts as a surrogate renal system, replicating the intricate functions of the kidneys and granting a renewed lease on life.

What are the types of hemodialysis?

Depending on where you undergo hemodialysis, it is of mainly two types: conventional in-center hemodialysis and home hemodialysis. 

  1. Conventional In-Center Hemodialysis:

It is the most common type of dialysis which is performed in a specialized dialysis center or a hospital. Patients visit the center for their scheduled dialysis sessions, usually three times a week. A lab technician closely monitors the process, ensuring the safety and effectiveness of the treatment.

As this type of dialysis is done in-center, 

You can have a dedicated team of medical experts on hand who can provide immediate assistance and support. In-center hemodialysis also provides an opportunity for patients to connect with others undergoing similar treatments, fostering a sense of community and shared experiences. 

  1. Home Hemodialysis:

This type of dialysis lets patients undergo the procedure in the comfort of their own homes. It is becoming increasingly popular as it offers greater flexibility and independence for kidney patients.

Unlike in-center dialysis, home hemodialysis requires a higher level of patient engagement and responsibility. Patients, along with their caregivers, receive extensive training to perform the dialysis procedure independently. 

Which one to choose?

Both conventional in-center hemodialysis and home hemodialysis are viable options for ESRD patients. The final choice must depend on factors such as patient preference, lifestyle considerations, and the availability of resources. 

By offering these diverse options, hemodialysis strives to accommodate the unique needs of each individual, ensuring a personalized and effective approach to renal care.

How does Hemodialysis work?

At its core, hemodialysis involves the utilization of a specialized machine known as a hemodialyzer, or dialysis machine. It serves as the epicenter of this transformative process. 

During a session, the patient’s blood is gently guided through a filtering unit of a machine called a dialyzer which separates the waste products from the blood. If not done properly, these waste products can accumulate and wreak havoc within the body.

As blood flows through the dialyzer, waste products, toxins, and excess fluid diffuse across the semipermeable membranes. Ultimately, ensuring that a delicate equilibrium is maintained.

But how does the blood reach the dialyzer? 

Hemodialysis requires vascular access, which is typically achieved through the creation of an AV fistula, graft, or the use of a vascular catheter. These access points allow the blood from the body to flow through the dialysis machine and back again. Therefore, allowing an uninterrupted cycle of purification.

How long will each hemodialysis treatment last?

Hemodialysis sessions typically last several hours and are performed multiple times per week, tailored to each individual’s specific needs. The duration and frequency of treatment are determined by severity of kidney dysfunction, overall health, and the advice of the medical team overseeing the process.

Normally, people who do hemodialysis at a dialysis center undergo the procedure 3 times per week for about 4 hours at a time. Whereas, kidney patients who choose to do hemodialysis at home may undergo the procedure 4-7 times per week for shorter hours each time.

Can hemodialysis be done daily?

Yes, hemodialysis can be performed daily, but the frequency of treatments can vary depending on individual needs and medical recommendations. 

Is hemodialysis expensive?

Yes, hemodialysis can be expensive. Depending on the country, healthcare system, insurance coverage, and individual circumstances, the expenses of hemodialysis can differ.

There are countries that offer government-funded healthcare programs or insurance options that may cover the cost of hemodialysis.

There are also some financial assistance programs that non-profit organizations offer to help mitigate the financial burden of hemodialysis for people.

Do I need to eat a special diet?

While there is no one-size-fits-all dietary prescription, people on hemodialysis often benefit from following a special diet tailored to their specific needs. This diet includes:

  1. Sodium Control:

Sodium is commonly found in table salt and processed foods such as chips which can contribute to fluid retention and increase blood pressure. For people on hemodialysis, sodium intake must be closely monitored and restricted. 

It involves minimizing the consumption of high-sodium foods such as fast food, canned soups, processed meats, and salty snacks. Choosing fresh food and seasoning thr dishes with herbs and spices can help reduce sodium intake while adding flavor.

  1. Fluid Restriction:

Since the kidneys’ ability to regulate fluid balance is compromised in kidney patients, it is essential to monitor and control fluid intake. 

Excessive fluid consumption can lead to fluid overload and result in complications such as edema, high blood pressure, and strain on the heart. Your Nephrologist will  provide you with a personalized fluid intake plan by considering urine output, weight changes, and residual kidney function.

  1. Protein Management:

Protein is an essential nutrient for overall health and body function. However, individuals on hemodialysis need to be mindful of their protein intake. 

Only a moderate intake of high-quality protein sources like lean meats, poultry, fish, eggs, and dairy products is recommended to prevent malnutrition and support muscle strength. 

Your specific protein requirements may vary depending on factors like body weight, muscle mass, and other individual considerations. It is better to discuss it with your Nephrologist. 

  1. Potassium and Phosphorus Control:

Maintaining proper potassium and phosphorus levels is essential for people on hemodialysis. Abnormalities in these electrolytes can lead to various health complications. 

Foods high in potassium, such as bananas, oranges, potatoes, and tomatoes must be limited or moderated. Similarly, phosphorus-rich foods like dairy products, nuts, and certain whole grains might also require restriction.

  1. Individualized Nutrition Plan:

It is important to recognize that each individual’s nutritional needs may differ depending on their specific medical condition, residual kidney function, and other factors. 

So, collaborating with a registered dietitian who specializes in renal nutrition is highly recommended. They can provide you personalized guidance, tailor dietary recommendations, and help you manage the special diet associated with hemodialysis.

Also read: Protein Supplements for Kidney Patients- What You Need to Know

Can dialysis cure my kidney disease?

Hemodialysis is a life-saving treatment for people with end-stage renal disease (ESRD) but it is NOT a cure for kidney disease. Dialysis serves as a means of replacing some of the essential functions of the kidneys when they are no longer able to perform adequately.

It does not address the underlying cause of kidney disease or reverse the damage that has already occurred to the kidneys. It is a supportive therapy that acts as a temporary measure until other treatment options, such as kidney transplantation, become available.

Will I be uncomfortable on hemodialysis?

Some individuals may experience mild discomfort during the insertion of the needles used to access the bloodstream. However, your lab technician will use local anesthesia to minimize any pain or discomfort during the needle insertion process. In some cases, using numbing creams can also reduce discomfort.

During the actual dialysis session, you may feel a slight sensation as your blood passes through the machine. However, the procedure is generally well-tolerated, and most people adapt to the sensation quickly. 

Can hemodialysis cause anemia?

Hemodialysis itself does not directly cause anemia. However, anemia is a common complication in individuals with kidney failure who require hemodialysis or other forms of renal replacement therapy. 

To overcome this issue physicians prescribe erythropoiesis-stimulating agents which stimulates the bone marrow to produce more red blood cells. Iron supplementation may also be necessary to support red blood cell production.

Anemia management in individuals on hemodialysis is a complex process and requires careful monitoring and adjustment of treatment. Typically, the best Nephrologists in India closely monitor blood counts, iron levels, and other relevant parameters to manage anemia management in dialysis patients.