{"id":162,"date":"2013-10-25T06:03:44","date_gmt":"2013-10-25T00:33:44","guid":{"rendered":"http:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=162"},"modified":"2013-11-01T14:11:21","modified_gmt":"2013-11-01T08:41:21","slug":"hemodialysis","status":"publish","type":"page","link":"https:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=162","title":{"rendered":"Hemodialysis"},"content":{"rendered":"<p align=\"left\">Previous: <a title=\"Dialysis\" href=\"http:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=152\">Introduction to dialysis<\/a><\/p>\n<h1>Hemodialysis<\/h1>\n<p align=\"justify\">To sum up the process of hemodialysis, it involves letting the blood from the patients body flow through an artificial filter, where it is purified. This &#8216;purified&#8217; blood is then returned back to patients body.<\/p>\n<h2 align=\"justify\">Requirements for Hemodialysis<\/h2>\n<ul>\n<li>An access for letting blood &#8216;in and out&#8217; of the body.<\/li>\n<li>A machine that will pump the blood and monitor the entire process.<\/li>\n<li>An artificial kidney ( dialyzer) that purifies blood of the toxins.<\/li>\n<li>A solution ( dialysate) that helps in the process of dialysis.<\/li>\n<\/ul>\n<h2><img decoding=\"async\" loading=\"lazy\" class=\"alignleft\" alt=\"\" src=\"http:\/\/www.kidneyadvice.net\/images\/AVG.png\" width=\"250\" height=\"350\" name=\"AVG\" \/>Access for Hemodialysis<\/h2>\n<p align=\"justify\">Commonest and most reliable access is the <a title=\"Dialysis\" href=\"http:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=152\">arterio-venous fistula ( AVF)<\/a>. It should be in place once the <span id=\"sprytrigger1\">CKD enters stage IV, i.e. <a title=\"Chronic Kidney Disease\" href=\"http:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=34\">estimated GFR<\/a> falls below 30 mL\/min.<\/span><\/p>\n<p align=\"justify\">The other forms of access include:<\/p>\n<ul>\n<li>arterio-venous Graft (AVG)<\/li>\n<li>Hemodialysis catheters\n<ul>\n<li>Non-cuffed<\/li>\n<li>Cuffed<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>Arterio-venous Graft (AVG)<\/h3>\n<p align=\"justify\">This is a synthetic tube that is placed between an artery and a vein and blood flows through it at a high velocity.<\/p>\n<p align=\"justify\">Unlike fistula, veins are not punctured. Instead, the synthetic tube is punctured to get blood flow for dialysis.<\/p>\n<p align=\"justify\">An AVG will be ready to use in two weeks time.<\/p>\n<h3 align=\"justify\">Hemodialysis Catheters<img decoding=\"async\" loading=\"lazy\" class=\"alignright\" alt=\"Caths\" src=\"http:\/\/www.kidneyadvice.net\/images\/Catheter.png\" width=\"250\" height=\"300\" \/><\/h3>\n<p align=\"justify\">These catheters are usually placed in the neck veins, but sometimes, in dire emergency have to be placed in the veins of the thigh.<\/p>\n<p align=\"justify\">Catheters are the choice when there is not enough time for the AVF or AVG surgery.<\/p>\n<p align=\"justify\">The non-cuffed catheters can be used only for a few weeks after which the rates of infections and loss of blood flow increase.<\/p>\n<p align=\"justify\">The cuffed catheters are placed through a small surgery and are ready to use immediately after placement. They can stay for upto two years.<\/p>\n<p align=\"justify\">Cuffed catheters are a choice when the veins in the wrist or elbow are too thin or not suitable for an AVF surgery.<\/p>\n<h2 align=\"justify\">Hemodialysis Circuit<\/h2>\n<h2 align=\"justify\"><img decoding=\"async\" loading=\"lazy\" class=\"alignright\" style=\"margin-left: 2px; margin-right: 2px;\" alt=\"HD\" src=\"http:\/\/www.kidneyadvice.net\/images\/HD%20Circuit.png\" width=\"380\" height=\"286\" \/><\/h2>\n<p align=\"justify\">Before we go further, let us understand the circuit of hemodialysis, i.e. how the blood flows, goes through the various components and returns to the body.<\/p>\n<p align=\"justify\">The blood is taken out through AVF or AVG ( or a catheter). This blood flow is mainatained at a good velocity with the help of a blood pump in the dialysis machine.<\/p>\n<p align=\"justify\">This blood then reaches the dialyzer (see below), where there are two compartments. One compartment contains the blood and the other contains the &#8216;dialysate&#8217;. These compartments are separated by a semi-permeable membrane. The actual &#8216;cleansing&#8217; of blood occurs here.<\/p>\n<p align=\"justify\">The clean blood is then returned to the body through a second needle in the veins or second &#8216;port&#8217; of the catheter.<\/p>\n<p align=\"justify\">Once the blood comes out of the body, it has a tendency to clot. To prevent this, a drug called &#8216;Heparin&#8217; is circulated through the circuit. This is done by a syringe pump located on the dialysis machine.<\/p>\n<p align=\"justify\">Pressures inside the circuit are monitored by the machine and any inadvertent air leak is trapped in the air chamber along the circuit.<\/p>\n<p align=\"right\">Next: <a title=\"Requirements\" href=\"http:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=169\">Dialyzer and HD machine<\/a><\/p>\n<!-- Anyway Feedback Container \/\/-->\n<div class=\"afb_container\" id=\"afb_comment_container_162\"><span class=\"message\">Is this Page useful?<\/span>\r\n<a class=\"good\" href=\"https:\/\/wp.kidneyadvice.net\/wordpress\/wp-admin\/admin-ajax.php\">Useful<\/a>\r\n<a class=\"bad\" href=\"https:\/\/wp.kidneyadvice.net\/wordpress\/wp-admin\/admin-ajax.php\">Not Useful<\/a>\r\n<span class=\"status\">1 of 1 people say this Page is useful.<\/span><input type=\"hidden\" name=\"post_type\" value=\"page\" \/>\n<input type=\"hidden\" name=\"object_id\" value=\"162\" \/>\n<\/div>\n<!-- \/\/Anyway Feedback Container -->","protected":false},"excerpt":{"rendered":"<p>Previous: Introduction to dialysis Hemodialysis To sum up the process of hemodialysis, it involves letting the blood from the patients body flow through an artificial filter, where it is purified. This &#8216;purified&#8217; blood is then returned back to patients body. Requirements for Hemodialysis An access for letting blood &#8216;in and out&#8217; of the body. A &#8230;<\/p>\n<p><a href=\"https:\/\/wp.kidneyadvice.net\/wordpress\/?page_id=162\" class=\"more-link\">Continue reading &lsquo;Hemodialysis&rsquo; &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/pages\/162"}],"collection":[{"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=162"}],"version-history":[{"count":6,"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/pages\/162\/revisions"}],"predecessor-version":[{"id":176,"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=\/wp\/v2\/pages\/162\/revisions\/176"}],"wp:attachment":[{"href":"https:\/\/wp.kidneyadvice.net\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=162"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}