Renal Failure

What to eat before and during the dialysis

Snacks and dietetic food

A light meal is recommended before your dialysis. At the beginning of the session you can have a snack, as previously prepared by the nutritionist.

You are allowed to bring your own snacks. Usually limited food (banana, grapes, chocolate, etc.) may be ingested during the first hour of your treatment. However, eating during dialysis increases the risk of hypotension, especially in elderly and diabetic patients.

Be careful and get advice from the nurse.

Installation

Several types of machines

When the time comes, the assistant nurse or the nurse will help you install at the place you are assigned for the session. We make available several types of machines (generators).

You may be assigned a different machine than the one used in the previous session, but this would not interfere with your treatment. Thus you should not be surprised or concerned when you are assigned a different place.

The conduct of a session

Assessing the weight gain

A hemodialysis session begins and ends with a weighing. The scales are the most reliable tools to assess the variation of weight between two sessions.

The weight gain is the amount of liquid that was not eliminated by your kidneys (water, tea, coffee, fruits, etc.). The higher it is, the more difficult the session will be to bear (risk of cramps, fatigue and hypotension).

It is recommended for the weight gain between two sessions to be less than 5% of the body weight.

Hemodialysis

Definition

Hemodialysis is a method of mechanically cleansing your blood outside the body.

The blood is carried by means of a machine to a filter which removes the toxins and excess water. After passing through this circuit, the filtered blood is returned to the body. In order to be able to access your blood, we use a vein of sufficient flow, being suggestively known as “vascular access”.

There are two types of vascular access:

The Fistula

Definition

A fistula is surgically created by connecting an artery and a vein in the arm. The vein (superficial, and easily accessible) will therefore be arterialised.

Thus, its size increases, its wall thickens and it becomes visible under the skin. And this facilitates the puncture and the pumping of a sufficient amount of blood (300 ml/ minute).

The passage of blood through the fistula is perceived upon palpation as a quiver (also called «thrill»).

The arteriovenous fistula is the preferred vascular access thanks to:

Two methods

Continuous ambulatory peritoneal dialysis (manual exchange) or CAPD

CAPD is a method that requires 4 to 5 exchanges of dialysate bags per day, in accordance with doctor’s instructions. Each bag exchange takes about 30 minutes.

In a first stage, you let the liquid full of toxic substances and excess water go through the catheter out of your abdominal cavity in an empty bag. Then, you fill again the abdominal cavity with dialysate coming from a preheated bag. This liquid will remain in your abdomen until the following bag exchange.

The peritoneal dialysis

Definition

Peritoneal dialysis is a method that uses the peritoneum (abdominal membrane) as a filter to clean the blood of toxic substances.

Method and objective

A fluid called dialysate is introduced, through a catheter, into the abdominal cavity in order to rebalance the blood plasma. Its components prompt the elimination of excess water and toxic substances produced by the body.

Self-treatment at home

The benefit for the patient is that he/she is independent and remains at home. As a first step, you learn the method at the hospital.

Insertion of the catheter

The Hospital Stay

The insertion of the peritoneal dialysis catheter takes about one hour. Before returning to your room, you will spend a few hours in the recovery room.

You will be lying down for 24 hours in order to prevent the catheter from moving. A control abdominal X-ray shall be then taken. The hospital stay will last from 48h to 72h.

It takes two weeks for the catheter to heal before being able to use it. Then you may commence the treatment.

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