Hemodialysis

Hemodialysis is a procedure and treatment used to cleanse the blood of waste products and excess fluid in patients with serious kidney disease. In hemodialysis, blood passes through a special machine (dialyzer) where it is filtered and cleaned of waste products and toxins that the kidneys normally remove from the body.

Hemodialysis may be recommended for patients with chronic kidney failure, acute poisoning, or other conditions that may affect kidney function. There are two main types of hemodialysis:

1. Hemodialysis with an artificial kidney(Hemodialysis on an artificial kidney, Hemodialysis with an artificial kidney machine): This method involves pumping blood through a special machine that filters the blood and returns it to the body. This process can be done several times a week and takes several hours.
2. Peritoneal dialysis: In this case, a special solution (dialysate) is injected into the patient's abdomen through a catheter that is usually placed in the abdomen. Blood is cleaned and filtered through the abdomen and then removed with the dialysate. This type of dialysis can be performed throughout the day, including overnight hours, and can be done at home, not just in a medical facility.

Hemodialysis plays an important role in maintaining life and improving the quality of life of patients with kidney failure. However, it is a medical procedure that requires constant monitoring and medical care.

The frequency of hemodialysis and the duration of hemodialysis may vary depending on medical indications and physician recommendations, as well as the patient's condition. Here are some general considerations:

1. Frequency of hemodialysis: Usually hemodialysis is done regularly, most often 3 times a week. However, in some cases, such as peritoneal dialysis or emergency blood purification, hemodialysis sessions may be more frequent.
2. Duration of hemodialysis: The duration of each hemodialysis session can vary, but is usually around 3-4 hours. But there are also shorter sessions, such as 2-2.5 hours, as well as longer sessions for patients with particularly severe conditions.
3. Individualized approach: The duration and frequency of hemodialysis can be tailored to the needs of the individual patient, depending on the patient's condition, level of kidney failure, and other factors. Physicians determine the optimal schedule based on medical evaluation.

It is important to understand that hemodialysis is a long-term procedure, and patients who need it are advised to adhere to their physicians' schedules and recommendations to maintain normal body function and improve quality of life.

Types of hemodialysis

There are several types of hemodialysis, depending on the methods and technologies used to clean the blood in patients with kidney failure. Here are the main types of hemodialysis:

1. Hemodialysis with Permanent Blood Access (PBA) (Hemodialysis with Arteriovenous Fistula or Graft): This is the most common type of hemodialysis. Patients are given special access to blood by surgically creating an arteriovenous fistula (AVF) or implanting a vascular shunt (graft). This access allows for a continuous hemodialysis procedure, and it is used to connect the patient to the dialyzer and dialysis machine.
2. Peritoneal Dialysis (PD): In peritoneal dialysis, a special solution called dialysate is injected into the abdomen through a thin, flexible tube that is placed inside the patient. The dialysate interacts with the abdominal peritoneal membranes, allowing toxins and excess metabolic products to be cleansed from the blood. This method of hemodialysis can be performed at home and is divided into continuous cyclic peritoneal dialysis (CCPD) and intermittent peritoneal dialysis (IPD).
3. Hemofiltration: This method of hemodialysis is used when more intensive removal of fluid from the patient's body is needed, such as in severe conditions or when fluid balance is compromised. Hemofiltration is done using a special machine that filters the blood, removing excess fluid and toxins.
4. Hybrid Dialysis: This approach combines elements of hemodialysis and peritoneal dialysis. Patients can have both treatments, depending on their needs and health status.
5. Home Hemodialysis: Some patients perform hemodialysis in the comfort of their own home. This may include day or night sessions of home hemodialysis, provided patients have received special training and can perform the procedure correctly.

Which type of hemodialysis is appropriate for a particular patient depends on the patient's condition, needs and capabilities. The decision to choose a hemodialysis method is usually made by the physician according to the individual clinical situation of each patient.

Stages of hemodialysis

The stages usually depend on the frequency and duration of the procedure, as well as the hemodialysis method chosen. The main stages of hemodialysis include:

1. Preparation Phase: During this phase, the patient is evaluated with a physical examination, blood tests, and renal function tests. The physician determines the need for hemodialysis and selects the appropriate method (e.g., continuous hemodialysis or peritoneal dialysis).
2. Access Placement: If hemodialysis with permanent blood access is chosen, an arteriovenous fistula (AVF) or a vascular shunt (graft) may be placed at this stage. These measures allow access to blood to be established for the hemodialysis procedure.
3. Equipment Setup: Medical personnel prepare the dialyzer, dialysis machine, and other necessary tools and equipment.
4. Hemodialysis Procedure: This stage involves performing the hemodialysis procedure itself, including connecting the patient to the dialysis machine, filtering the blood, and returning the purified blood back into the body.
5. Monitoring: During hemodialysis, medical staff closely monitor the patient's condition and parameters such as blood pressure, pulse rate, and fluid and electrolyte levels.
6. Procedure Completion: When the hemodialysis procedure is complete, medical personnel disconnect the patient from the dialysis machine, assess the patient's general condition, and check blood access.
7. Post-Dialysis Care: After hemodialysis, the patient may require additional care and monitoring, including taking medications and maintaining diet.

Hemodialysis is usually performed regularly, most often several times a week. Patients may have alternating hemodialysis days and rest days. The stages of hemodialysis may vary depending on the method chosen and the individual needs of the patient.

Indications for the procedure

Indications for hemodialysis include:

1. Chronic renal failure: Hemodialysis may be prescribed for patients with chronic renal failure when their kidney function has deteriorated to such an extent that they are unable to effectively cleanse the blood of toxins and metabolic wastes.
2. Acute kidney injury: Hemodialysis may be required in patients with acute kidney injury, such as poisoning, infection, trauma, or surgery, when the kidneys are temporarily unable to clear blood.
3. Hyperkalemia: High levels of potassium in the blood (hyperkalemia) can be dangerous to the cardiovascular system. Hemodialysis may be used to lower blood potassium levels.
4. Swelling and excess fluid: Hemodialysis can help eliminate swelling and excess fluid in patients who cannot regulate fluid balance on their own.
5. Urinary problems: Patients suffering from urinary disorders may require hemodialysis to remove excess fluid and toxins from the body.
6. Uremic syndrome: This is a condition in which toxins and metabolic wastes accumulate as a result of insufficient kidney function. Hemodialysis is used to reduce the levels of these substances in the blood.
7. Diabetes mellitus: Patients with diabetes mellitus, especially if they are on sugar-lowering drugs and insulin, may develop chronic renal failure (diabetic nephropathy). Hemodialysis may be prescribed if renal function is severely impaired.
8. Acute renalfailure: Acute kidney injury may require temporary hemodialysis to maintain life and restore renal function.
9. Hepatitis: Hemodialysis may be considered for severe complications associated with hepatitis, such as hepatitis-related encephalopathy and azotemic syndrome, when the kidneys cannot properly process hepatic waste.
10. Oncology: Patients with cancer may have acute or chronic renal failure due to the cancer itself, chemotherapy treatment or other factors. Hemodialysis may be prescribed in such cases to sustain life and improve the patient's quality of life.

Hemodialysis can be performed as a temporary procedure in emergency situations or regularly if the patient has chronic kidney failure. The treating physician determines the need and duration of hemodialysis, as well as the frequency of hemodialysis, based on the clinical picture and the patient's condition.

At what creatinine is hemodialysis prescribed?

The administration of hemodialysis depends not only on the creatinine level in the blood, but also on the patient's general clinical condition, symptoms of renal failure, and other factors. The creatinine level is an important indicator, but it is not the only criterion for determining the need for hemodialysis.

Typically, hemodialysis may be considered in the following cases:

1. Symptoms of renal failure: If a patient has symptoms of severe renal failure such as swelling, high blood pressure, nausea, vomiting, decreased appetite, sleep disturbance, etc., combined with a high creatinine level, this may be an indication for hemodialysis.
2. Blood creatinine level: Hemodialysis is usually considered when blood creatinine levels are significantly elevated and do not respond to drug treatment. Hemodialysis is usually indicated for patients with severe renal failure, when kidney function is reduced to the point where they are unable to effectively remove wastes and toxins from the blood. The creatinine level at which hemodialysis is considered can vary depending on the clinical situation, but is usually greater than 5-10 mg/dL (or 442-885 µmol/L).
3. Patient condition: The decision to undergo hemodialysis may also depend on the patient's general condition, the presence of complications, their age, and the presence of comorbidities.

Doctors usually determine the need for hemodialysis on a patient-by-patient basis. If you suspect kidney failure or your blood creatinine level is significantly elevated, it is important to see your doctor to evaluate your condition and make appropriate medical decisions.

Preparation

Preparing for hemodialysis is an important step to help ensure the procedure is done safely and effectively. Hemodialysis is used to cleanse the blood in people with chronic kidney failure. Here are the basic steps to prepare for hemodialysis:

1. Choice of place and time: Hemodialysis can be performed in dialysis centers or at home (with proper equipment and training). The patient and doctor will choose the best place and time for the procedure.
2. Choosing a type of hemodialysis: There are two main types of hemodialysis, reverse osmosis hemodialysis (ROH) and direct osmosis hemodialysis (DOH). Your doctor will help you choose the most appropriate type based on your health and preferences.
3. Preparation of vascular access: In order to perform hemodialysis, it is necessary to have access to a blood vessel. This can be created surgically through an artery and vein (shunt) or with a catheter. Your doctor will decide which access method is most suitable for you.
4. Training and supervision: If you are going to have hemodialysis at home, you will need training on how to do the procedure correctly and how to take care of yourself. Your doctor and nurses will monitor you and give you the support you need.
5. Regular blood tests: You will be scheduled for regular blood tests to monitor your creatinine, urea, and other levels. This will help your doctor monitor the effectiveness of the procedure.
6. Diet andfluid control: Your doctor and dietitian may recommend a special diet and fluid restriction to reduce the strain on your kidneys and improve hemodialysis results.
7. Medications: If necessary, your doctor may prescribe medications to control your blood pressure, blood calcium and phosphorus levels, and others.
8. Prepare mentally: Hemodialysis is a long-term procedure and it is important to prepare mentally. Discuss your expectations and concerns with your doctor and get support from a psychologist or support group.

Preparing for hemodialysis requires attention to detail and cooperation with your medical team. Follow your doctor's recommendations and make sure you have a good understanding of how to maintain your health during hemodialysis.

Hemodialysis catheters

These are special medical devices that are used to create access to a patient's circulatory system to perform hemodialysis procedures. They are inserted into large veins and are used to carry blood from the patient's body to and from the hemodialysis machine.

There are several types of catheters that can be used for hemodialysis:

1. Direct access catheter (CVC - Central Venous Catheter): This is a type of catheter that is usually inserted into the subclavian vein, connects to a large vein and has two or three holes to collect and return blood. It is convenient for temporary use and can be placed fairly quickly, but is often not recommended for long-term use because of the risk of infection and blood clots.
2. Arteriovenous catheter (AV catheter): This type of catheter connects an artery and a vein to form an arteriovenous opening. It is designed for long-term use and may provide better access to blood.
3. Peritoneal catheter: Used for peritoneal dialysis, not hemodialysis. It is inserted into the abdomen and is used to infuse dialysis solution and drainage inside the abdomen.

Hemodialysis catheters are strictly sterilized and medically treated before use to minimize the risk of infection. They should also be regularly maintained and inspected to ensure safety and effectiveness.

It is important to note that the choice of catheter type and how it is used depends on the individual needs and condition of the patient, as well as the recommendations of the medical team. Hemodialysis catheters should be inserted and maintained by medical professionals trained in this area to minimize risks and ensure the safety of the procedure.

Technique of the hemodialysis

The procedure is performed using special medical equipment that filters the blood and returns it to the body.

Here are the basic steps and technical aspects of performing hemodialysis:

1. Patient preparation: Before starting the procedure, the patient is attended to by a doctor and a nurse. They check the patient's condition, measure blood pressure and other important parameters.
2. Catheter insertion: If the patient does not have permanent access to blood (usually created surgically, e.g. By creating an arteriovenous fistula), the doctor inserts a special catheter into one of the large veins (most commonly the subclavian or subclavian vein). The catheter is used to connect to a hemodialysis machine.
3. Connecting to the machine: The patient is connected to the dialysis machine, which has two main parts: the dialyzer and the machine with control and pumping devices. The patient's blood enters the dialyzer through a catheter, where it passes through a membrane, allowing toxins and waste products to pass through.
4. Blood filtration: The dialyzer filters the blood to remove excess substances such as urea, creatinine and excess electrolytes from the blood. The purified blood is then returned back to the patient's body through another pipeline.
5. Monitoring: The hemodialysis procedure is continuously monitored by medical staff. They monitor blood pressure, heart rate and other important parameters to ensure patient safety.
6. Fluid and electrolyte monitoring: Doctors and nurses also monitor the levels of fluids and electrolytes in the patient's body to prevent disturbances in the water-electrolyte balance.
7. End of session: At the end of the hemodialysis procedure, the medical staff disconnects the patient from the machine, removes the catheter (if it was temporary), and assesses the patient's general condition.

Hemodialysis is usually performed on a regular basis, and the length of a session can vary depending on the patient's condition and the doctor's recommendations. The process is performed by specially trained health care professionals in clinics and hospitals.

Hemodialysis machine (or hemodialysis machine)

This is specialized medical equipment used to perform hemodialysis procedures. Hemodialysis is a method of artificially cleansing the blood of toxins, excess fluid and metabolic waste in patients with impaired kidney function.

Hemodialysis machines typically include the following components and functions:

1. Blood Circuit: This is the system of tubes and filters through which the patient's blood passes. Blood leaves the body through a catheter or other access to the bloodstream, passes through the filtration system, and returns back to the body.
2. Filter (dialyzer): A filter is used to remove toxins and excess fluid from the blood. It contains a membrane that allows molecules of a certain size and chemical compounds needed to maintain chemical balance in the body to pass through.
3. Pumps: The hemodialysis machine is equipped with pumps that allow blood to move through the blood circuit and filter.
4. Monitoring and Control: The machine is equipped with a monitoring system that monitors blood parameters such as blood pressure, blood flow, electrolyte concentration and others. Medical personnel can monitor and adjust these parameters to ensure a safe and effective procedure.
5. Drug Dispensers: Some hemodialysis machines may have built-in drug dispensers that add needed medications or solutions to the blood stream to adjust the chemistry.

Hemodialysis machines come in a variety of models and features, including the ability to perform different types of hemodialysis such as Hemodiafiltration (Hemodiafiltration), Peritoneal Dialysis (Peritoneal Dialysis), or Continuous Renal Replacement Therapy (CRRT) depending on the patient's needs.

These machines are used in specialized medical facilities, such as dialysis centers and hospitals, under the supervision of trained medical personnel. Hemodialysis is an important procedure to maintain life and improve the quality of life of patients with chronic kidney failure or acute kidney failure.

How does hemodialysis work?

The operation of hemodialysis is based on the principles of filtration and diffusion.

That's how hemodialysis works:

1. Preparation for the procedure: The patient undergoes special preparation before starting hemodialysis. This involves inserting a catheter into an artery and vein (usually around the forearm or thigh) to allow access to blood. Blood from the patient is pumped through the catheter into a dialyzer (hemodialysis machine).
2. Dialyzer (artificial kidney): A dialyzer is a special device that contains many membranes through which blood passes. On the other side of the membranes is dialysate, a liquid that mimics kidney function. The dialyzer and dialysate interact with the blood to allow excess substances and fluid to be filtered out.
3. Filtration: The procedure begins when the patient's blood enters the dialyzer. Inside the dialyzer, filtration begins due to the difference in concentration of substances between the blood and dialysate. Waste products such as urea, creatinine, and electrolytes pass from the blood into the dialysate through the membranes, while beneficial substances remain in the blood.
4. Venous blood return: The purified blood is returned back into the patient's body through another catheter in the vein. This process can take several hours and is usually performed several times a week, depending on the degree of kidney failure.

Hemodialysis can replace kidney function in patients with severe kidney failure, ensuring that toxins and excess fluid are cleared from the blood. This helps to keep these patients alive and improves their quality of life.

Arteriovenous fistula for hemodialysis

An arteriovenous fistula (AV fistula) is a surgically created connection between an artery and a vein, usually in the forearm or upper arm of a patient, that is used to provide access to the circulatory system during hemodialysis. Here's how it works:

1. Creating a fistula: The surgical process involves creating a small arteriovenous connection. This is usually done in the area of the forearm or hand.
2. Fistula development: Once a fistula is created, it takes time for it to heal and develop. Over the course of a few weeks or months, arterial blood begins to flow into a vein, increasing blood flow in the area.
3. Hemodialysis use: Once the fistula is sufficiently developed, it is ready for use during hemodialysis. Medical personnel can insert needles into the fistula to drain blood from the artery into the dialyzer and return the purified blood back into the vein.

The advantages of an arteriovenous fistula for hemodialysis include reliable access to blood, lower risk of infection compared to other access methods (e.g., catheters), and long-term effectiveness. AV fistulas can be used for many years, providing the necessary blood flow for hemodialysis. Establishing and caring for a fistula requires some skill and medical supervision to maintain its functionality and prevent complications.

Home Hemodialysis (Home Hemodialysis)

This is a hemodialysis procedure that is performed at home under the supervision of the patient or their loved ones. This treatment method is used for patients with chronic kidney failure who are trained and able to perform the procedure on their own or with minimal assistance. Here are some key aspects of home hemodialysis:

1. Training: Patients who choose home hemodialysis receive training on how to properly perform the procedure. This includes training in the use of dialysis equipment, aseptic technique (cleanliness), safety precautions and control of their own health.
2. Equipment selection: Patients are provided with dialysis equipment that is suitable for use in the home. This may include a hemodialysis machine and necessary supplies.
3. Regular sessions: Patients performing home hemodialysis usually have dialysis sessions several times a week. The length and frequency of sessions depend on the physician's recommendations and the patient's needs.
4. Diet and medication adherence: Patients need to follow a diet, monitor fluid intake, and take medications as recommended by their physician to maintain electrolyte balance and minimize the burden on the kidneys.
5. Medical monitoring: The doctor and medical team regularly monitor the patient's condition, perform blood tests and evaluate the effectiveness of the procedure.
6. Support Services: Patients performing home hemodialysis have access to medical support and can seek help when needed.

Home hemodialysis can give patients more flexibility and improve their quality of life, as they can manage their dialysis sessions more independently and schedule them according to their schedule. However, it requires responsibility and discipline on the part of the patient, as well as good support from the medical team. Before deciding on home hemodialysis, it is important to discuss all aspects of this procedure with your physician and receive appropriate training.

Program hemodialysis

This is the term commonly used to describe modern computerized hemodialysis systems. These systems use software to automate and control the hemodialysis process, making it more accurate and safer for patients. Here are some of the main aspects of software hemodialysis:

1. Parameter Control: The software monitors and adjusts multiple parameters such as blood flow rate, dialysate rate, anticoagulant level and others to ensure optimal efficiency and safety of the procedure.
2. Individualized dose calculation: Program hemodialysis systems can tailor procedure parameters to individual patient needs based on the patient's physiological characteristics and level of renal impairment.
3. Patient Monitoring: The software continuously monitors the patient's condition and procedure parameters, alerting medical staff to any abnormalities or problems.
4. Safety Management: These systems can automatically monitor the level of anticoagulant in the patient's blood to prevent blood clots from forming during hemodialysis.
5. Data archiving: Software hemodialysis equipment typically stores data from each treatment, which can be useful for monitoring and analyzing treatment effectiveness.
6. Improved patient comfort: With more precise parameter control and quieter operation, program hemodialysis can create a more comfortable environment for patients.

Program hemodialysis improves the quality and safety of the procedure and makes the work of the medical staff easier. It is an important advance in the treatment of patients with renal failure.

Portable hemodialysis

It is an innovative technology that is being developed to facilitate the hemodialysis procedure and increase the mobility of patients suffering from chronic kidney failure. The basic idea behind the portable hemodialysis system is to enable patients to perform hemodialysis not only in a clinic or dialysis center, but also at home, on the road or away from home, improving their quality of life and independence.

Here are some key features of portable hemodialysis systems:

1. Small size and light weight: Portable hemodialysis units are compact and lightweight, making them easy to carry and use outside the clinic.
2. Battery powered: They are often battery or battery operated, allowing patients to perform the procedure even in the absence of a constant power source.
3. User-friendly operation: Portable hemodialysis systems typically feature an intuitive interface that allows patients to easily monitor and adjust procedure parameters.
4. Ability to perform different types of hemodialysis: Some portable systems support different hemodialysis techniques, including peritoneal dialysis and intensive dialysis (CRRT).
5. Mobility: Patients can perform hemodialysis at home, while working or traveling, which increases their independence and improves their quality of life.
6. Continuity of procedure: Some portable systems allow hemodialysis to be performed continuously, which can be particularly useful for patients with more serious conditions.

Portable hemodialysis systems are under active research and development. They have the potential to significantly improve the care of patients with renal failure, reduce the need for frequent clinic visits and improve their quality of life. However, they also present technical and clinical challenges and require strict medical supervision and patient education before use.

Contraindications to the procedure

Hemodialysis is an important procedure for many patients with kidney failure, but some people may have contraindications or limitations to this procedure. Contraindications to hemodialysis may include the following:

1. Lack of access to blood vessels: Hemodialysis requires access to blood vessels, usually through an artery and a vein. If the patient does not have suitable vessels or they cannot be accessed, this may be a contraindication.
2. Severe heart failure: In patients with severe heart failure and unstable circulation, hemodialysis may be dangerous.
3. Systemic infections: If a patient has systemic infections such as sepsis, hemodialysis may be delayed until the infection is cleared.
4. Poor general condition: In some cases, when the patient has severe complications or persistent deterioration of general condition, hemodialysis may not be administered.
5. Allergic reaction to anticoagulants: Anticoagulants (blood thinners) are used in the hemodialysis process, and if the patient is allergic to these drugs, this may be a contraindication.
6. Excess body fluid: Hemodialysis is used to remove excess fluid from the body, but if the level of excess fluid is too high, hemodialysis can be more difficult and dangerous.

These are only general contraindications and each case is evaluated individually by a physician. Patients requiring hemodialysis should discuss their medical conditions and contraindications with their nephrologist or dialysis specialist to determine if hemodialysis is an appropriate method for them and what alternatives may be available if contraindications exist.

Consequences after the procedure

After a hemodialysis procedure, the patient may experience various physical and psychological effects. It is important to note that the effects can vary depending on the duration and frequency of hemodialysis, as well as the individual characteristics of the patient. Here are some of the possible effects after hemodialysis:

1. Hypotension: After hemodialysis, some patients may experience a drop in blood pressure, which can cause dizziness, weakness, or fainting. This may be due to changes in the volume of blood in the body during the procedure.
2. Fatigue and weakness: Hemodialysis can cause physical and mental fatigue. This may be due to the procedure itself as well as painful conditions that required hemodialysis.
3. Posthemodialysis syndrome: Some patients may experience symptoms such as headache, nausea, vomiting, and muscle pain after a hemodialysis procedure. This is called posthemodialysis syndrome and may be caused by changes in blood count and electrolyte balance.
4. Infections: Because hemodialysis is done through a catheter or creates access to blood, there is a risk of developing infections, especially in patients spending long periods of time on hemodialysis. It is important to follow strict hygiene precautions.
5. Psychological aspects: Patients undergoing hemodialysis may experience psychological burdens such as depression, stress, anxiety, and feelings of dependence on the procedure.
6. Dietary changes: Patients on hemodialysis often need to watch their diet and limit their intake of certain foods to control electrolyte and waste levels in the blood.
7. Medical complications: There is a risk of developing medical complications related to hemodialysis, such as bleeding, infections, or problems with blood access.

It is important to maintain open communication with medical staff and physicians to address concerns and discuss any worries after hemodialysis. Effective treatment and care can help reduce adverse effects and improve the patient's quality of life.

Complications after the procedure

Hemodialysis is an effective procedure for clearing waste products from the blood in patients with kidney failure, but like any medical procedure, it can come with complications. Some of the complications that can occur after a hemodialysis procedure include:

1. Hypotension (low blood pressure): Hemodialysis may cause a decrease in blood pressure, which may lead to feelings of dizziness, weakness, or even loss of consciousness.
2. Infections: Patients undergoing hemodialysis may be at risk for infections, especially if a catheter is used to access blood.
3. Bleeding: Hemodialysis requires access to blood vessels, and this may increase the risk of bleeding or blood clots.
4. Muscle Crumps: Blood electrolyte levels can change during hemodialysis, which can lead to muscle crumps and pain.
5. Dialysate Intolerance: Some patients may experience allergic reactions or non-infectious shock due to the dialysate used in the procedure.
6. Desiccation: Hemodialysis can remove not only toxins but also beneficial elements from the blood. Patients may therefore be at risk of desiccation.
7. Electrolyte disorders: The procedure may cause disturbances in the blood electrolytes such as potassium, sodium, and calcium.
8. Bone structure disorders: Hemodialysis can affect the metabolism of calcium and phosphorus in the body, which can lead to bone structure problems.

These complications can be controlled and minimized with careful monitoring and medical care. It is important that patients undergoing hemodialysis maintain regular check-ups, adhere to treatment recommendations, and follow the physician's advice.

Care after the procedure

Care after a hemodialysis procedure is important to ensure your comfort and safety. Here are some recommendations for care after hemodialysis:

1. Rest: It is important to give yourself time to rest after the procedure. You may feel weak or tired, so rest for a few hours.
2. Keep access clean: If you have a hemodialysis catheter or shunt in place, make sure the insertion site is clean and dry. In addition, monitor the insertion site for signs of infection, such as redness, swelling, or soreness. If you experience any of these symptoms, contact your doctor immediately.
3. Monitor your fluid intake: Your doctor may prescribe a fluid restriction. Follow these recommendations to avoid fluid accumulation in your body.
4. Follow yourdiet: Eat according to your doctor's and dietitian's recommendations. This will help maintain electrolyte balance and minimize stress on the kidneys.
5. Use medication: If you are prescribed medication, take it strictly as prescribed by your doctor.
6. Monitor your blood pressure: If you have problems with your blood pressure, it is important to measure it regularly and follow your doctor's recommendations.
7. Maintain hygiene: Wash your hands regularly with soap and water. This will help prevent infections.
8. Follow activity recommendations: Your doctor can give you recommendations for physical activity after hemodialysis. Follow these recommendations to maintain your overall health.
9. Monitor your symptoms: Be aware of how you feel and report any unusual symptoms or sensations to your doctor immediately.
10. Follow your doctor's advice: It is important to follow all recommendations and prescriptions given to you by your health care professional. This will help you maintain optimal health.

In addition, communicate regularly with your health care team and follow their recommendations. Hemodialysis is a long-term procedure and it is important to maintain your health and quality of life afterward.

Nutrition in hemodialysis, weekly menu

During hemodialysis, it is important to watch your diet, as proper nutrition helps to maintain electrolyte balance and minimize stress on the kidneys. Here is an example of a weekly hemodialysis menu:

Day 1:

• Breakfast: Protein omelet with vegetables, grapefruit.
• Afternoon snack: Buckwheat with olive oil and greens.
• Lunch: Stewed kurcha with vegetables (broccoli, cauliflower, carrots), buckwheat.
• Afternoon snack: Cottage cheese with honey.
• Dinner: Fish stew with lemon and greens, steamed green beans.

Day 2:

• Breakfast: Muesli with non-fat yogurt and berries.
• Afternoon snack: Green smoothie (banana, spinach, milk alternative).
• Lunch: Fish stew with lemon and herbs, mashed sweet potatoes, steamed green beans.
• Afternoon snack: Cucumber and tomato salad with olive oil.
• Dinner: Grilled veal, quinoa, fresh vegetable salad.

Day 3:

• Breakfast: Buckwheat with milk alternatives and nuts.
• Afternoon snack: Cottage cheese with honey.
• Lunch: Grilled chicken breast, quinoa, fresh vegetable salad.
• Afternoon snack: Buckwheat with cottage cheese.
• Dinner: Stewed kurcha with vegetables (broccoli, cauliflower, carrots).

Day 4:

• Breakfast: Protein omelet with vegetables, orange.
• Afternoon snack: Cucumber and tomato salad with olive oil.
• Lunch: Fried chicken, mashed sweet potatoes, steamed green beans.
• Afternoon snack: Buckwheat with olive oil and greens.
• Dinner: Stewed kurcha with vegetables (broccoli, cauliflower, carrots).

Day 5:

• Breakfast: Muesli with non-fat yogurt and berries.
• Afternoon snack: Green smoothie (banana, spinach, milk alternative).
• Lunch: Grilled veal, quinoa, fresh vegetable salad.
• Afternoon snack: Cottage cheese with honey.
• Dinner: Fish stew with lemon and greens, broccoli.

Day 6:

• Breakfast: Buckwheat with milk alternatives and nuts.
• Afternoon snack: Buckwheat with cottage cheese.
• Lunch: Grilled chicken breast, quinoa, fresh vegetable salad.
• Afternoon snack: Cottage cheese with honey.
• Dinner: Stewed kurcha with vegetables (broccoli, cauliflower, carrots).

Day 7:

• Breakfast: Protein omelet with vegetables, orange.
• Afternoon snack: Cucumber and tomato salad with olive oil.
• Lunch: Fried chicken, mashed sweet potatoes, steamed green beans.
• Afternoon snack: Buckwheat with olive oil and greens.
• Dinner: Fish stew with lemon and greens, broccoli.

This is just a sample menu and can be customized to meet the specific needs and recommendations of your doctor or dietitian. It is important to follow your health care professional's recommendations and monitor your fluid, protein, phosphorus, potassium and sodium intake according to your health and blood test results.

Disability

Hemodialysis alone is not a basis for a disability. Disability is assigned on the basis of a person's general health and ability to work, not solely because of the need for hemodialysis.

However, indications for hemodialysis are chronic kidney failure and other serious kidney diseases that can significantly affect the patient's overall health. If a person's health deteriorates to such an extent that he or she is unable to work and perform normal daily activities due to kidney pathology, then he or she may apply for a disability rating based on his or her general health.

The process of assigning a disability varies by country and jurisdiction. It usually involves contacting the medical board or social services, providing medical documents and medical reports, and having specialists evaluate the patient's health and functional limitations. The decision to assign a disability is based on this data.

Clinical Guidelines

Clinical guidelines for hemodialysis are developed by medical organizations and experts in nephrology (the academic discipline of kidney disease) and may vary from country to country and from one medical practice to another. However, it is important to follow general principles and guidelines to ensure the safety and effectiveness of hemodialysis. The following are general clinical guidelines for hemodialysis:

1. Indications for hemodialysis: Hemodialysis is indicated for patients with chronic kidney failure or acute kidney dysfunction when the kidneys are unable to effectively clear toxins and excess fluid from the blood.
2. Assessment: Before hemodialysis begins, a detailed assessment of the patient's condition is performed, including a physical examination, laboratory tests, and review of medical history.
3. Choosing a hemodialysis method: There are various hemodialysis methods, including in-clinic hemodialysis, home peritoneal dialysis, and portable systems. The method is chosen depending on the clinical situation and patient preference.
4. Frequency and duration: The frequency and duration of hemodialysis sessions may vary depending on the degree of renal impairment and the patient's medical condition.
5. Medical supervision: Hemodialysis should be carried out under strict medical supervision, and patients should regularly visit dialysis centers or other medical facilities.
6. Monitoring parameters: During hemodialysis, blood parameters such as blood pressure, blood flow, electrolyte levels and hemoglobin should be monitored.
7. Dietary control: Patients on hemodialysis are often advised to follow a special diet, limiting the intake of certain foods and electrolytes.
8. Prevention of complications: Medical staff should watch for possible complications such as infections, bleeding, and blood access problems and take steps to prevent and treat them.
9. Patient support: Patients on hemodialysis may face physical and psychological stresses, and it is important to provide support and education on self-care.
10. Planning for the future: Patients on hemodialysis may have questions about kidney transplantation or other treatments. It is important to discuss plans for the future with their medical team.

Clinical guidelines for hemodialysis are updated regularly, and patients should contact their physicians and health care professionals for up-to-date information and advice based on their individual needs and health status.

Predictions

The prognosis for patients on hemodialysis depends on many factors, including age, general health, causes of kidney failure, and quality of care. It is important to realize that hemodialysis is a life-saving procedure for patients with severe kidney failure, and it allows them to continue living and maintaining their overall health.

Here are some key aspects that may affect the prognosis of patients on hemodialysis:

1. General health: The better the patient's general health, the better the prognosis. However, many patients start hemodialysis with pre-existing chronic conditions that can also affect their prognosis.
2. Adherence to recommendations: Adherence to physician recommendations, including hemodialysis regimen, diet, medication intake, and self-care, plays an important role in prognosis. Patients who are actively involved in taking care of their health have a more favorable prognosis.
3. Quality of care: The quality of care and access to modern treatment methods also affect prognosis. Timely treatment of complications and monitoring of the patient's condition play an important role.
4. Causes of kidney failure: The causes of kidney failure can vary. For example, kidney failure caused by diabetes or hypertension may have a different prognosis than kidney failure caused by other causes.
5. Age: Age also affects prognosis. Younger patients often have a better prognosis than older patients.

Overall, modern treatments and careful care can significantly prolong the life of patients on hemodialysis. Many patients successfully live on hemodialysis for many years. It is important to continue to maintain an active lifestyle, follow medical recommendations, and maintain a positive attitude. Each situation is unique and prognosis may vary, so it is important to discuss your individual situation with your physician.