In a healthy human body, the kidneys filter waste products, harmful substances found in food and water, and excess fluids from the blood and eliminate them from the body through the urinary system. However, in some cases, kidneys that have become deformed over time may not be able to perform this function wholly or partially. In such situations, hemodialysis is applied. Although hemodialysis is not a treatment for kidney failure, it helps to control blood pressure and balance essential minerals such as potassium, sodium, and calcium in the blood.
During hemodialysis, blood passes through a machine called a dialyzer, which acts as a filter. The dialyzer, also known as an artificial kidney, plays a crucial role at the beginning of the treatment. A dialysis nurse or technician inserts two needles into the patient at the start of hemodialysis. Each needle is attached to a soft tube connected to the dialysis machine. The machine filters the blood from the patient and returns the purified blood to the body. During the process, the dialysis machine controls the blood pressure.
After being trained by the healthcare team, patients can insert their needles for long-term treatment. If the insertion of the needles causes discomfort to the patient, a numbing cream or spray can be used.
With modern dialysis machines, patients are attached to the machine for a designated period of one week, and the functions that healthy kidneys perform over seven days in a healthy body are carried out within approximately 10-12 hours per week using the machine.
Artificial kidneys, also known as dialyzers, cannot perform all the functions of organic kidneys, but they can perform some of the tasks that the kidneys cannot. Therefore, the artificial kidney is an instrument and part of the hemodialysis method. To ensure the success of the hemodialysis process, the patient must pay attention to diet and treatment rules. Limiting certain fluids and foods during the diet can help prevent excess fluid buildup in the body.
Hemodialysis treatment is conducted at dialysis centers. Treatment schedules are programmed according to the condition of the patient's kidneys, usually ranging from three to five times a week. Each dialysis session lasts approximately four hours, and treatment programs are adjusted according to the patient's age, profession, daily routine, and biological and physiological characteristics.
For patients who do not have the opportunity or time to go to dialysis centers, home hemodialysis services are available. These services include standard, daily, and nightly treatments, and treatment programs are implemented according to the doctor's recommendations.
If hemodialysis treatment is regularly applied, the success rate of the process is high. The patient's energy level and appetite may increase. Hemodialysis reduces salt and fluid accumulation, so the patient's shortness of breath and swelling may decrease.
To benefit from hemodialysis treatment in the best way, the ideal "dry weight" should be maintained. Perfect dry weight is measured when no excess fluid is in the body. During the hemodialysis application process, if attention is paid to sodium intake, the ideal dry weight should be reached at the end of each hemodialysis session. If hemodialysis treatments are beneficial and, superior dry weight is maintained, blood pressure is controlled, and the risk of a heart attack is minimized.
It is essential for patients undergoing hemodialysis treatment to pay attention to what they eat and drink. Alcoholic, acidic, and carbonated beverages, as well as fatty, salty, and sugary foods, should be consumed very carefully. In addition, foods with high levels of sodium and phosphorus should be avoided, and the amount of fluid consumed, including fluids in foods, should be controlled. Otherwise, fluid accumulation in the patient's body may occur during hemodialysis treatment.
The following nutrition rules should be followed during hemodialysis:
- Protein should be added to the diet.
- Foods containing the correct amount of potassium should be selected.
- Vitamin supplements that help with kidney failure can be taken.
The hemodialysis process involves using various tools and equipment, such as a water purification system, dialysis solution, dialyzer, and hemodialysis sets. In the initial stage, the water purification system filters substances in the kidneys. A water purifier allows toxic substances to be removed from the body without accumulation in accumulations.
Water purification systems use filtration methods such as softening, activated carbon filters, and deionization. Additionally, toxic substances in the water can be filtered out before they reach the kidney using ultrafiltration, distillation, and other methods.
The hemodialysis solution selects ions that must be present in the patient's blood, ensuring that essential minerals required for the kidneys are obtained. The proper ratios of substances such as sodium, potassium, calcium, magnesium, chloride, glucose, bicarbonate, and acetate necessary for the hemodialysis process can be determined through this method.
Before receiving treatment with a dialysis machine, different treatment options can be applied according to the patient's preference and the opinions of expert doctors. These include peritoneal dialysis and organ transplantation options.
Peritoneal dialysis is performed by filtering blood through a point called the peritoneum. The peritoneal cavity stores and filters the solution used in dialysis. Excess fluid and toxic substances are eliminated from the body through peritoneal dialysis. Experts can prefer peritoneal dialysis according to the patient's condition and preference. It is a frequently used method for people with heart and vascular diseases. This method can also be used in kidney diseases commonly seen in children due to limited vascular access. This dialysis method, which can be applied at home, is preferred mainly to prevent disruption of the education of school-aged children.
Kidney transplantation is usually the last resort in the treatment of kidney diseases. In this process, a joint decision is made by the nephrology specialist and the person who will perform or receive the kidney transplant as a result of the treatment. Organ transplantation can be considered in cases of complete kidney failure.