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By Mayo Clinic staffIf you had sudden or acute kidney failure, you may need hemodialysis only for a short time until your kidneys recover. But most people with chronic kidney failure need hemodialysis for the rest of their lives unless they can get a kidney transplant.
Although conventional hemodialysis is more common, some studies suggest that more frequent hemodialysis is linked to better quality of life, increased well-being and reduced symptoms. Your appetite, sleeping patterns, energy level and ability to concentrate may improve, while symptoms such as cramping, headaches and shortness of breath are less likely.
Your hemodialysis care team will monitor your treatment to make sure you're getting the right amount of hemodialysis to remove enough wastes from your blood. About once a month, your blood will be tested by using one of two formulas — urea reduction ratio (URR) or total urea clearance (Kt/V). Your care team may adjust your hemodialysis intensity and frequency based, in part, on the test results.
Your access blood flow will also be monitored at least once a month. This is done using sound waves (ultrasound) to measure the speed of blood flow during hemodialysis.
Eating the right foods can improve your hemodialysis results and your overall health. While you're receiving hemodialysis, you'll need to carefully monitor your intake of fluids, protein, sodium, potassium and phosphorus. A dietitian can help you develop an individualized meal plan based on your weight, your personal preferences, your remaining kidney function and other medical conditions, such as diabetes or high blood pressure.
Taking your medications as prescribed also is important for achieving the best possible results. While you're receiving hemodialysis, you'll need various medications to keep your body's fluid level and electrolytes, such as sodium and potassium, in balance. Your doctor also may prescribe blood thinners to prevent clots in the hemodialysis machine and tubing, blood pressure medication to control your blood pressure, and erythropoietin to stimulate your bone marrow to produce new red blood cells.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/atoz/content/hemodialysis.cfm. Accessed Oct. 19, 2010.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis. Accessed Oct. 19, 2010.
- Himmelfarb J, et al. Hemodialysis. In: Brenner BM, et al. Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-3105-5..50060-8&isbn=978-1-4160-3105-5&type=bookPage§ionEid=4-u1.0-B978-1-4160-3105-5..50060-8--cesec2&uniqId=223035191-9. Accessed Oct. 19, 2010.
- Hemodialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch234/ch234b.html. Accessed Oct. 19, 2010.
- Crawford PW, et al. Treatment Options for End Stage Renal Disease. Primary Care: Clinics in Office Practice. 2008;35:407.
- Schmidt RJ, et al. Psychiatric illness in dialysis patients. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2010.
- Perl J, et al. Home hemodialysis, daily hemodialysis, and nocturnal hemodialysis: Core curriculum 2009. American Journal of Kidney Diseases. 2009;54:1171.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 23, 2010.
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