Care plan is a virtual coach to manage Care Plan for Hemodialysis better. It gives you regular messages about
alarm signs, Do’s / Dont’s, Nutrition, Diet, Exercises and Reminders to improve your health
How does it benefit you?
Address common questions, FAQs about Care Plan for Hemodialysis
Save time with concise validated information and reminders
Remove waste, salt and extra water to prevent them from building up in your blood
Keep a safe level of certain chemicals in your blood
Help to regulate blood pressure
How does hemodialysis work?
A hemodialysis machine has a special filter called a dialyzer, or artificial kidney, to clean your blood. To get your blood into the dialyzer, the doctor needs to make an access, or entrance, into your blood vessels. This is done with minor surgery, usually to your arm.Three different types of access can be made : a fistula, a graft or a catheter.
A fistula is the first choice for an access. It is made by joining an artery to a nearby vein under your skin to make a bigger blood vessel. This type of access is preferred because it has fewer problems and lasts longer. You should be evaluated by a special doctor called a vascular surgeon at least six months before you will need to start dialysis. A fistula should be placed early (several months before starting dialysis) so it has plenty of time to heal and be ready by the time you need treatment.
If your blood vessels are not suitable for a fistula, a graft may be used. This involves joining an artery and nearby vein with a small, soft tube made of synthetic material and placed under your skin.
After the fistula or graft has healed and dialysis is started, two needles will be placed - one in the artery side and one in the vein side of the access - every time you go for treatment. The needles are connected to plastic tubes. One tube carries your blood to the dialyzer where it is cleaned and the other tube returns the cleaned blood back to you.
The third type of access, called a catheter, is inserted into a large vein in your neck or chest. This type of access is generally used when you need dialysis for a short period of time. Catheters may be used as a permanent access but only when a fistula or a graft cannot be placed. Catheters can be connected directly to the dialysis tubes and needles are not used.
How does the dialyzer clean my blood?
The dialyzer, or filter, has two parts - one part for your blood and the other part for a washing fluid called dialysate. A thin membrane separates these two sides. Blood cells, protein and other important things remain in your blood because they are too big to pass through the membrane. Smaller waste products such as urea, creatinine and extra fluid pass through the membrane and are removed. Changes in the dialysate or cleansing fluid can be made for your special needs.
How long will each hemodialysis treatment last?
Hemodialysis treatments are usually done three times a week. Each treatment lasts about four hours, but you may need more time to ensure that enough wastes and fluid are removed. The amount of dialysis you need depends on:
How much your own kidneys are working
How much fluid weight you gain between treatments
How much you weigh
How much waste you have in your blood
The type of artificial kidney used by your dialysis center
Can dialysis cure my kidney disease?
In some cases of sudden (also called acute) kidney failure, dialysis may only be needed for a short time until the kidneys get better. However, when CKD progresses slowly over time to kidney failure, your kidneys do not get better. You will need dialysis for the rest of your life unless you are able to receive a kidney trans-plant.
Your primary healthcare provider will tell you how frequently your hemodialysis catheter will need to be replaced. If you need more dialysis sessions, you may need to have surgery to make an arteriovenous fistula (AVF) or arteriovenous graft (AVG). If you had surgery for an AVF or AVG, your primary healthcare provider or nephrologist need to check to make sure it is healing properly. Write down your questions so you remember to ask them during your visits.
Arteriovenous fistula or graft care:
When your AVF or AVG is healed and functioning well, you may need to care for it by yourself. Follow these instructions:
Clean the skin over the fistula or graft daily with soap and water.
Take the bandage off the fistula or graft 4 to 6 hours after dialysis.
Check your fistula or graft each day for good blood flow by touching it with your fingertips. The buzzing sensation means that it is working.
Check for bleeding, pain, redness, or swelling. These may be signs of infection or a clogged fistula or graft.
Prevent damage to the fistula or graft. Do not let anyone take your blood pressure or draw blood from the arm that has the fistula or graft. Do not sleep on that arm. Do not wear tight clothes or jewelry.
Once you get used to your treatment, you should feel a lot better. In fact, you may feel more like doing the activities you enjoyed before your kidney disease developed.
Medications are available to treat your anemia and keep your bones healthy so you will feel stronger and less tired.Contact your doctor regarding same.
Can people on dialysis continue to work?
Yes. Many dialysis patients continue to work or return to work after they have gotten used to dialysis. If your job requires a lot of physical labor (heavy lifting, digging, etc.), you may need to change your duties.
Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables.
Add plenty of Whole Grains (whole wheat flour, brown rice, whole beans, millets like bajra, ragi, jowar).
Choose foods high in Good Fat such as olive oil, peanut oil, fatty fish, walnuts, flaxseeds.
It's important to stick to your fluid, sodium (salt), potassium, phosphorus limits so you don't build up too much fluid and minerals in your body between treatments. This build-up may lead to the need for more fluid removal (ultrafiltration) during your dialysis treatment. Ultrafiltration may cause some discomfort during your treatment.
1. It is critical to limit the amount of Sodium in your diet and help prevent too much fluid build-up and maintain blood pressure. To do so,
No table salt and cook with herbs and spices instead of salt.
Read food labels; choose foods low in sodium.
Avoid canned, processed, packaged and frozen foods.
2. Limit fruits and vegetables high in Potassium such as banana, mango, chikoo, dry fruits, tomatoes, chocolates. To leach out potassium From vegetables, soak the diced vegetable in either warm water for 4 hours or in cold water overnight before cooking. Any fruit if consumed should be done so just before dialysis, so that potassium can be removed from the body during dialysis.
3. Unlike normal kidneys, dialysis cannot remove Phosphorus entirely; therefore it is important to limit its intake. High blood phosphorus can lead to renal bone disease and itchy skin. Avoid phosphorus rich foods such as - milk, paneer, curd, meats, fish, nuts.
4. Limit Fluid and water intake, usually to 4 cups a day. Talk to your doctor to learn about your limits. Remember, whatever melts at room temperature like ice cubes, Jello-O, lollypops count towards fluid intake.
Try to drink only when you are thirsty.
Sip the drink instead of gulping it.
Suck on hard candy, imili goli, lemon wedges or chewing gum to help keep your mouth moist without having to drink liquids.
Suck on frozen lemon juice cubes instead of drinking water.
Lower the salt consumption, lesser the thirst.
Avoid caffeinated drink like tea, coffee, cola.
5. Do not drink alcohol. Alcohol can make your kidney failure worse.
6. Avoid cooking with coconut or coconut oil.
Sample Diet Plan (patient with Hypertension)
Check portion sizes for each food by going to these links.(6)(7) Do not add SALT or SUGAR while cooking or as seasoning. For cooking, use only Olive oil or Peanut oil.
2 White bread toast OR 2 Steamed Idlis with 1 tablespoon coriander chutney
1 egg omellete
1/2 Apple OR Guava OR 1/2 Cup Guava
1/4 Cup of Hot Water with some lemon
Early Morning Snack
1/4 Cup Brown rice Poha OR Plain upma OR 1 Cup of Popcorn (unsalted and unbuttered)
2-3 cubes of Frozen lemonade ice cubes
2-3 Multigrain phulka OR Jowari Roti
1 Cup Plain Dal OR 1 Cup Rajma
1 Cup Potato (leached) curry (Recipe)
1/2 Cup Plain Curd
Early Dinner Snack
4 Ragi Biscuits OR Whole wheat crackers OR 3 Vanilla wafers with Honey on them
1Cup Brown rice with Masoor/Channa Dal OR 1 Cup Brown rice Khichadi with 1/2 small bowl of Raita
1 Cup Cabbage curry OR Bottle gourd (Lauki) OR Cauliflower curry
1/4 Cup Hot water
Late Night Snack
1/2 Cup Skim milk infused with Saffron
Life Long Instructions
It is never too late to adapt a healthy lifestyle. Talk to your doctor and dietician about dietary restrictions. Take the recommended medicines on time.
Eat foods that are low in saturated fats and cholesterol. Avoid foods high sodium, potassium, phosphorus and fluid content. If overweight or obese, loose the extra kilos and maintain a healthy weight. Quit smoking and cut down on alcohol. Check your blood pressure regularly.