Preparing for Haemodialysis

1)What is haemodialysis?

Answer: Haemodialysis is one of the available renal replacement therapies. It involves using a haemodialysis machine to clear the toxins from your body. Usually you need a vascular access so that the haemodialysis machine can be connected to your body. Blood will be withdrawn from your body and goes through the machine so that ‘clean’ blood can be returned back to your body.It is usually done 3 times a week with 4 hours in each session.

2) What is a vascular access?

Answer: Vascular access is the ‘bridge’ between you and the haemodialysis machine. It can be either a catheter ( tunneled/ non tunneled) fistula or a graft.

It is crucial for you to take care of your vascular access because it is describes as the ‘life line’ of a haemodialysis patient.

3) What is the best vascualr access?

Answer:Of course it is the fistula due to 3 reasons, it can last longer, it has less complications and the infection rate is much lower. You should go for fistula creation as soon as possible and you must bear in mind that 30 and up to 50% of patients might not be able to get the fistula functioning after the first operation.

4) What is tunneled or non-tunneled catheters?

Answer: Tunneled catheters are inserted under special procedure and major portion of the catheter is buried under the skin whereas non-tunneled catheter is exposed without a cuff. Studies have shown that tunneled catheters is a better option due to longevity and less infection. However, insertion of catheters is not without risk, possible complications include bleeding, pneumothorax, injury to the heart/vessels or even death!

5) How long can my catheter last?

Answer: Usually tunneled catheters can last longer due to lesser infection, however, it all depends on site of insertion/ tunneled or non tunneled etc. You can use your catheter as long as it is not infected!

6) Where to find a dialysis centre?

Answer: You can download the list of haemodialysis centre from the following website,

www.PassPACES.com/download/dialysis_centre.pdf

7) When can I use my fistula after operation?

Answer: Usually you need to wait for about 6 weeks, however sometimes due to urgency of the matter, after a proper assessment using ultrasound, your nephrologist might decide to use the fistula earlier than 6 weeks or even just 2 weeks post creation.

8) How long can my fistula last?

Answer:

• It depends! It depends on your blood vessels, site of your fistula and whether there is complication during haemodialysis.
• Your nephrologist can not predict the life span of your fistula but he might be able to pick a failing fistula so that intervention can be done hoping the fistula can last longer.

9) Can I switch to peritoneal dialysis now?

Answer: YES. Every renal replacement therapy compliments each other. It is not uncommon patients switching from one modality to another.

10) Can I do shorter duration/ less 3x/week dialysis?

Answer: It is certainly not recommended however, you might want to discuss this with your nephrologist if there are some financial constraints.

11) How much is the treatment cost per month?

Answer:It depends on the nature of your dialysis centre. It is much cheaper if you can find a NGO centre, otherwise private hospital-based dialysis centre or stand alone dialysis centres are equally expensive. The cost can be up to RM3000 per month.

12) Follow Up

Answer: A follow – up appointment for review by the doctor will be made for you upon discharge from the ward. Chronic dialysis patients need life long regular follow up.

13) Phone enquiries

Answer: It would be appreciated if you could also restrict all telephone enquires to the listed visiting times and nominate one family member to make calls due to the busy nature of the ward/clinic. Thank you.

Download this information sheet!