The first step in haemodialysis is a relatively simple surgery to create access to your blood vessels.
This usually only needs to be done once, as the access stays in place for your treatments, and is usually done a few weeks before your first dialysis session. Access is created in one of three ways: by a fistula, whereby a direct connection is made between an artery and a vein, creating a strong vessel to withstand the regular insertion and removal of needles; by a graft, whereby a similar connection is made indirectly via a plastic tube; by a Y-shaped catheter, where a plastic tube is inserted directly into a larger vein. If you have a fistula or graft, at the start of each HD treatment, two needles are placed into the vascular access, one allowing blood to flow into the dialysis machine, and one allowing it to flow back into your body from the machine.
Sterile plastic tubes (bloodlines) carry your blood into the dialysis machine. The key part of this machine is the dialyser, a series of thin semipermeable membranes which acts as a barrier between your blood and the dialysis fluid. These membranes allow substances to move out of and into your blood and in this way waste products and excess water are removed from your body and medication may also be given. The dialysis circuit carries blood at 200-300 ml/min, flow at >350ml/min. A complete dialysis session usually takes 4-5 hours and is repeated at least 3 times every week.
You are encouraged to relax during the dialysis treatment, by reading, sleeping, working, watching television etc. Nurses will keep a very close eye on you throughout your dialysis and ensure that the machine is working correctly.
Dialysis should not be painful, but it is common to feel tired afterwards, a side-effect which can be alleviated by adjusting your diet and taking regular exercise. You may feel sick, dizzy or have muscle cramps during dialysis, and are always encouraged to seek help from our medical teams.