Hemodialysis

Hemodialysis

In the field of medicine, hemodialysis (also known as haemodialysis) is a technique used for extracorporeal removal of waste products like creatinine and urea, as well as excess water from the blood in cases of renal failure. Hemodialysis constitutes one of the three primary renal replacement therapies, alongside renal transplant and peritoneal dialysis. Apheresis presents an alternative method for extracorporeal separation of blood components, such as plasma or cells.

Hemodialysis can be administered as either an outpatient or inpatient therapy. Typically, routine hemodialysis takes place in a specialized dialysis outpatient facility, either within a hospital or in a standalone clinic. Alternatively, hemodialysis may be conducted at home, albeit less commonly. In clinic settings, dialysis treatments are initiated and overseen by specialized staff, comprising nurses and technicians. Conversely, home-based dialysis treatments may be self-administered or performed with the assistance of a trained caregiver, often a family member.

While hemodialysis may be utilized for acute kidney failure, it is more commonly employed for managing chronic renal diseases. In cases of end-stage kidney disease, hemodialysis is frequently employed, often on a fixed schedule of three sessions per week.

There exist various types of dialysis, including peritoneal dialysis. Specifically, there are three types of hemodialysis: conventional hemodialysis, daily hemodialysis, and nocturnal hemodialysis.

Conventional hemodialysis typically involves three sessions per week, each lasting approximately 3–4 hours. During these sessions, the patient's blood is drawn out through a tube and circulated through a dialyzer, before being returned to the patient's bloodstream. Blood pressure and other vital signs are closely monitored throughout the procedure.

Daily hemodialysis, usually undertaken by patients performing dialysis at home, is less taxing but requires more frequent access. It typically involves shorter sessions performed six days a week.

Nocturnal hemodialysis resembles conventional hemodialysis but is conducted overnight, three to six nights a week, for six to ten hours per session while the patient sleeps.

Advantages of hemodialysis include a low mortality rate, better blood pressure control, fewer dietary restrictions, and improved solute clearance. However, disadvantages include restrictions on independence, the need for additional supplies and reliable technology, and the complexity of the procedure. Hemodialysis machines, which pump the patient's blood and dialysate through the dialyzer, are continuously monitored for safety parameters by highly computerized systems.