A unit committed to excellent health care delivery and patient wellbeing. The hemodialysis unit was set up to cater for the needs of patients with acute kidney injury and end stage kidney failure with a Glomerular Filtration Rate (GFR) of <15.

Dialysis is a life support treatment involving the process of removing excess fluid, solutes and toxins from the blood in people whose kidneys can no longer perform this function naturally. There are two types of dialysis treatment option namely, hemodialysis and peritoneal dialysis. Our unit offers hemodialysis as treatment option.

Treatment is usually done three (3) sessions per week. Hours per treatment session ranges from three to four hours. Some patients have two (2) sessions in a week due to substantial residual kidney function and sometimes due to financial reasons.

A doctor/nephrologist upon assessment will recommend hemodialysis as treatment option for a client/patient. It’s upon a doctor’s request the unit will commence hemodialysis treatment.

He will also give a prescription that indicates the number of sessions a patient will require based on patient’s kidney function, overall health, signs and symptoms presenting, personal preferences etc.

Indications of acute kidney disease

Indications for Chronic Kidney Disease

Once hemodialysis is the preferred treatment option, the patient undergo series of laboratory investigations to confirm diagnosis prior to commencement of treatment.

The patient is introduced to the unit, the staff, unit protocols, cost involved and an agreed treatment session schedule is given. Treatment schedules are on out-patient basis. Treatment schedules does not include Sundays.

Hemodialysis Treatment
This is a procedure where a dialysis machine and a special filter called an artificial kidney or dialyzer is used to clean or filter the blood. Substances such as urea, creatinine, potassium, salt and excess fluid are filtered from the blood.

To begin hemodialysis treatment a doctor needs to create an access into the patient’s blood vessels to access blood into the dialyzer/artificial kidney. This is called the vascular access.

The vascular access is created by minor surgery. The vascular access could come in a fistula, graft or catheter.

Arteriovenous (AV) fistula: It is considered the best long term vascular access for Hemodialysis. Here the surgeon creates the fistula by joining an artery directly to a vein in the arm Arteriovenous (AV) Graft: With the Graft the surgeon uses a soft plastic/synthetic tube and connects it to an artery and a vein under the skin in the arm.

Venous Catheter: This is used temporarily when patient is unable to wait for the maturation of AV fistula (which takes 6 to 8 weeks) or graft (which takes about 2 weeks). A tube is inserted into the vein in the neck or the chest i.e. the jugular or subclavian vein respectively and spigot with heparin. It is not a permanent access because it can easily clog, get infected and cause narrowing of the veins in which they are placed.

Preparation for hemodialysis treatment begins by checking of patient’s vital signs and recorded, access site inspected and cleansed for treatment.

If your access is a fistula or graft, your nurse or technician will place two needles into the access at the beginning of each treatment. These needles are connected to soft tubes that go to the dialysis machine. Your blood goes to the machine through one of the tubes, gets cleaned in the dialyzer, and returns to you through the other tube.

If your access is a catheter, it can be connected directly to the dialysis tubes without the use of needles.

Monitoring of our patient is key during treatment till completion of treatment and discharging of patient to continue with their normal activities till next hemodialysis session.

Some complications during dialysis include hypotension, anemia, muscle cramps, febrile reactions, arrhythmia, hemolysis, disequilibrium syndrome, nausea and vomiting, headache, chills and fever, chest pain, itching, hypertension, access site complications (infection, aneurysm) etc.

Clients Expentations

Clients Responsibilities

Follow up/Review
The unit is run on out-patient basis, hence all patients after treatment over a period is required to see a nephrologist who visits the unit once every week or make bookings to see their respective medical practitioners.

Quality Assurance