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Date issued: October 2023

Review date: October 2025

Ref: B-495/JM/Renal/Haemodialysis

PDF: Haemodialysis final October 2023.pdf [pdf] 766KB

This leaflet is designed to:

• Explain haemodialysis as a treatment

• Dialysis access

• Where you can have Haemodialysis

• Explain possible complications of Haemodialysis

Introduction

Choosing the right treatment option for you can seem very daunting when you have chronic kidney disease (CKD) that is sufficiently advanced for your kidney team to start talking to you about renal replacement options.

Your decision needs to be guided by your personal lifestyle, support at home and any other illnesses you may have.

Each type of treatment has its own benefits and points to think  about before you make a decision. It is therefore important that you are given information, advice and guidance to enable you to decide on the treatment that’s best for you.

What is Haemodialysis?

Haemodialysis is a treatment which removes waste products and fluid from your blood when your own kidneys are no longer able to do this.

How does haemodialysis work?

Haemodialysis treatment replaces the cleaning function that your kidneys normally undertake. Your blood is taken out of your body and travels round a dialysis     machine and through a special filter called a dialyser.

The dialyser cleans your blood of waste products and removes any extra fluid, then the clean blood is returned to your body. Only a small amount of your blood (a small tea cup) is out of your body at any one time. For haemodialysis to take place there needs to be a reliable way of getting access to your blood stream so that your blood can be passed through the dialysis machine.

The best way of getting access to your blood stream for haemodialysis is to have a fistula made (see Your Guide to Haemodialysis Access Leaflet).         

A fistula is where an artery and a vein in your arm are joined together to make one strong vein to use for haemodialysis. This allows two needles to be inserted into your bloodstream, one needle takes the blood out to be cleaned and the other returns clean blood back into your blood stream.

A Fistula

Sometimes haemodialysis may be needed before a fistula has been made or has matured and ready to use. If this happens then a haemodialysis line will be placed in through the skin into one of the large veins in the neck or groin temporarily until your fistula is ready to use.

How often will I have dialysis?

Most people on haemodialysis need to have three dialysis treatments a week and each treatment lasts on average for 4 hours.

Where can I have my Haemodialysis?

Unit based haemodialysis - we have several dialysis units in Devon and Cornwall, Estover, Kingsbridge, Launceston and Holsworthy (please see map opposite) and will endeavour to get you into the unit nearest to where you live once you are established on dialysis.

Home Haemodialysis -  once you are established on haemodialysis at the unit and you would like to consider having home dialysis, you will need to discuss this with the nurse in charge in the unit. They will assess your suitability and you would need to have help from a family member or friend to undertake home haemodialysis and be fully trained to perform your treatment at home. You will be visited every 4 weeks for monthly bloods and
support by one of the dialysis nurses.

What are the risks associated with having

Haemodialysis?

• Low blood pressure caused by the drop in fluid levels during HD: Low blood pressure can cause nausea and dizziness. This can be resolved by adjusting the fluid removal during treatment.

• Infection of the dialysis line or fistula: This can cause high temperatures and dizziness; it can be   treated with antibiotics. If the infection is severe in a line, it may need to be removed and another one inserted.

• Infection in the blood from the dialysis line or fistula: This can cause high temperatures, dizziness and if severe can be life threatening, however it can usually be treated with antibiotics.

• Muscle cramps: Usually in the lower legs. This is thought to be caused by the muscles reacting to the fluid loss that occurs during HD and can often be resolved by adjusting the fluid removal during treatment. 

• Itchy skin: Caused by a build-up of toxins (poisons) in body between dialysis sessions. We can prescribe a medicine to help with this and dietary advice may also help.

• Bleeding from the fistula: If prolonged or severe you may need a blood transfusion and/or further surgery to the fistula.

• Blockage of the dialysis line or fistula: This may mean that the blood flow around the dialysis machine is poor making the treatment less effective. You would need to have some tests to assess the severity of the blockage and possibly an operation on the fistula or a new line inserted.

Useful Contacts

CKD Team

You can contact us on the below number Monday to Friday, 8am to 4pm. If your query is not urgent please leave a message and we will get back to you.

01752 430310

For any urgent queries out of hours please contact Mayflower Ward on 01752 431485

Below are other useful contacts within the department

• Dietitian 01752 439961
• Plymouth Dialysis Unit 01752 431700
• Kingsbridge Dialysis Unit 01752 438250
• Saltash Dialysis Unit 01752 278451
• Holsworthy Dialysis Unit 01626 923807