Hemodialysis

Hemodialysis for acute renal failure may be done daily until kidney function returns.

What To Expect After Treatment

About once a month, you will have blood tests to make sure you are getting the right amount of hemodialysis. These tests are done to help find out how well hemodialysis is working. Your weight before and after each session will be recorded, as will the length of time it takes to complete the dialysis session. If you have hemodialysis at home, you will need to keep records of your weight before and after each session and the length of each session.

Why It Is Done

Hemodialysis is often started after symptoms or complications of kidney failure develop. Symptoms or complications may include:

• Signs of uremic syndrome, such as nausea, vomiting, loss of appetite, and fatigue.
• High levels of potassium in the blood (hyperkalemia).
• Signs of the kidneys' inability to rid the body of daily excess fluid intake, such as swelling.
• High levels of acid in the blood (acidosis).
• Inflammation of the sac that surrounds the heart (pericarditis).

Hemodialysis is sometimes used when sudden (acute) kidney failure develops. Dialysis is always used with extra caution in people who have acute renal failure, because dialysis can sometimes cause low blood pressure, irregular heart rhythms (arrhythmias), and other problems that can make acute renal failure worse.

How Well It Works

Hemodialysis may improve your quality of life and increase your life expectancy. But hemodialysis provides only about 10% of normal kidney function. It does not reverse chronic kidney disease or kidney failure.

Dialysis has not been shown to reverse or shorten the course of acute renal failure. But it may be used when fluid and electrolyte problems are causing severe symptoms or other problems. Some people who develop acute renal failure stay dependent on hemodialysis and will go on to develop kidney failure.

Risks

Most complications that occur during dialysis can be prevented or easily managed if you are monitored carefully during each dialysis session. Possible complications may include:

• Low blood pressure (hypotension). This is the most common complication of hemodialysis. It is seen more often in women and in people older than 60.
• Muscle cramps. If cramps occur, they usually happen in the last half of a dialysis session.
• Irregular heartbeat (arrhythmia).
• Nausea, vomiting, headache, or confusion (dialysis disequilibrium).
• Infection, especially if a central venous access catheter is used for hemodialysis.
• Blood clot (thrombus) formation in the venous access catheter.
• Technical complications, such as trapped air (embolus) in the dialysis tube.