Haemodialysis is a medical procedure that removes waste and fluid from the blood using an artificial kidney machine and dialyzer. It was pioneered by Dr. Willem Kolff in 1943. Conditions like acute renal failure and chronic renal failure can necessitate haemodialysis when they lead to acid-base imbalances, electrolyte abnormalities, fluid overload, or uremia. The goals of haemodialysis are solute clearance and fluid removal through diffusion and ultrafiltration across a semi-permeable membrane. It requires a dialyzer, dialysis solution, blood tubing, and a machine. Access points like arteriovenous fistulas and catheters are used to connect the patient's blood to the
2. DEFINITION
A medical procedure to remove fluid and waste
products from the blood and to correct electrolyte
imbalances. This is accomplished using a machine
and a dialyzer, also referred to as an "artificial kidney."
3. Dr. WILLEM KOLFF
FATHER OF DIALYSIS
HE WAS THE FIRST TO CONSTRUCT A WORKING
DIALYSER IN 1943
4. CONDITIONS WHICH LEADS TO
HAEMODIALYSIS
1. ARF
a. Decreased renal blood flow
b. Damage to kidneys
c. Hydronephrosis
2. CRF
a. DM (40%)
b. Hypertension (25%)
c. Glomerulonephritis
5. INDICATIONS
Acid base imbalance ( pH< 7.1)
Electrolyte imbalance ( K+ > 6.5 mEq/ L)
Intoxication (Alcohol or drug intoxication)
Overload of fluids ( pulmonary oedema)
Uremic syndrome (↑ed level of urea & CR)
7. PRINCIPLES OF HAEMODIALYSIS
1. DIFFUSION : Passive movement of solute across a
semipermeable membrane
2. ULTRAFILTRATION : Solute + fluid removal across
semipermeable membrane down a pressure gradient
12. DIALYSATE
A solution used in dialysis to draw fluids and
toxins out of the blood stream and supply electrolytes
and other chemicals to the blood stream.
Contents of dialysate
Na+ : 137 mEq/L
K+ : 2 mEq/L
Ca++ : 7 mg/dl
Mg++ : 0.75 mEq/L
Cl- : 108 mEq/L
HCO3-- : 35 mEq/L
21. Assessment of patient before
dialysis
1. Weight
2. Serum biochemistry , serology and haematology
3. Blood pressure
4. Temperature and pulse
5. Assessing Hepatitis B vaccination status
BEFORE HD
Take consent
Verification of physician’s order
26. Complications of haemodialysis
1. Hypotension
2. Muscle cramps
3. Loss of blood
4. Air embolism
5. Hypoglycemia
6. Dialyser reaction
7. Disequilibrium syndrome
8. Haemolysis
9. Sepsis
10. Vascular steal
27. Post dialysis care
Needle site care
Monitoring of post HD vitals
Collection of sample for post HD investigations
Administration of medication such as Inj. Espogen
Measurement of weight
Diet education & fixing next appointment