Dialyzer
The
dialyzer is a large canister containing thousands of small
fibers through which your blood is passed. Dialysis solution,
the cleansing fluid, is pumped around these fibers. The fibers
allow wastes and extra fluids to pass from your blood into
the solution, which carries them away. The dialyzer is sometimes
called an artificial kidney.
Reuse
Your
dialysis center may use the
same dialyzer more than once
for your treatments. Reuse is
considered safe as long as the
dialyzer is cleaned and disinfected
before each use. The dialyzer
is tested each time to make
sure it's still working, and
it should never be used for
anyone but you. Before each
session, you should be sure
that the dialyzer is labeled
with your name and check to
see that it has been cleaned,
disinfected, and tested.
High flux/high efficiency
In
recent years, dialysis researchers
have developed dialyzers with
membranes that allow more rapid
filtering of wastes and fluid.
High-flux or high-efficiency
dialysis allows for more complete
and efficient removal of wastes
and fluids. To keep your blood
pressure from going too low,
your dialysis team will need
to watch carefully to make sure
that fluid isn't removed from
your body too quickly. These
responses aren't usually dangerous,
and many people have reported
that high-flux dialysis, by
removing more waste within a
shorter time period, helps them
feel better.
Dialysis Solution
Dialysis
solution, also known as dialysate, is the fluid in the dialyzer
that helps remove wastes and extra fluid from your blood.
It contains chemicals that make it act like a sponge. Your
doctor will prescribe a specific dialysate for your treatments.
This formula can be adjusted based on how well you tolerate
the treatments and on your blood tests.
Needles
Many
people find the needle sticks to be one of the most unpleasant
parts of hemodialysis treatments. Most people, however, report
getting used to them after a few sessions. If you find the
needle insertion painful, an anesthetic cream or spray can
be applied to the skin.
Most
dialysis centers use two needles--one to carry blood to the
dialyzer and one to return the cleaned blood to your body.
Some specialized needles are designed with two openings for
two-way flow of blood, but these needles are less efficient
and require longer sessions. Needles for high-flux or high-efficiency
dialysis need to be a little larger than those used with regular
dialyzers.
Arterial
and venous needles
Some
people prefer to insert their
own needles. You'll need insertion
training to learn how to prevent
infection and protect your vascular
access. You may also learn a
"ladder" strategy
for needle placement in which
you "climb" up the
entire length of the access
session by session so that you
don't weaken an area with a
grouping of needle sticks. An
alternative approach is the
"buttonhole" strategy
in which you use a limited number
of sites but insert the needle
precisely into the same hole
made by the previous needle
stick. Whether you insert your
own needles or not, you should
know these techniques to better
care for your access.
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