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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 kidney failure need dialysis for the rest of their lives unless they can get a kidney transplant.
Your dialysis 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 dialysis intensity and frequency based, in part, on the test results.
Your access blood flow will also be monitored once a month. This is done using ultrasound (sound waves) to measure the speed of blood flow during hemodialysis.
Eating the right foods can improve your dialysis 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. Your dietitian will 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.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis. Accessed Dec. 5, 2008.
- Dialysis in the treatment of renal failure In: Fauci AS, et al, eds. Harrison's Principles of Internal Medicine. 17th ed. United States of America: The McGraw-Hill Companies Inc.; 2008. http://www.accessmedicine.com/popup.aspx?aID=2881062&print=yes. Accessed Aug. 24, 2008.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/ATOZ/atozItem.cfm?id=35. Accessed Aug. 24, 2008.
- Berns JS. Patient information: Hemodialysis. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Berns JS. Patient information: Renal replacement therapy. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Berns JS. Patient information: Chronic kidney disease. http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2008
- Kliger AS. Frequent nocturnal hemodialysis - A step forward? Journal of the American Medical Association. 2007;298:1331.
- Mailloux LU. Dialysis modality and patient outcome. http://www.uptodate.com/home/index.html. Accessed Aug. 26, 2008.
- Ricci Z, et al. Dose and efficiency of renal replacement therapy: Continuous replacement therapy versus intermittent hemodialysis versus slow extended daily dialysis. Critical Care Medicine. 2008;36(suppl):S229.
- McFarlane PA, et al. The quality of life and cost utility of home nocturnal and conventional in-center hemodialysis. Kidney International. 2003;64:1004.
