Hemodialysis - Definition, Principles, Procedure, Complications

1. HEMODIALYSIS
BY
SURENDRAN RADJOU

2. DEFINITION
Hemodialysis is a process that uses a man-made membrane
(dialyzer) to:
• Remove wastes, such as urea, from
the blood.
• Restore the proper balance of
electrolytes in the blood.
• Eliminate extra fluid from the body.

3. INDICATIONS
• Metabolic Acidosis
• Electrolyte Imbalance
• Overload Of Fluid
• Acute Poisoning
• Uremia
• Renal Failure
• Lowered Glomerular Filtration Rate (GFR)

5. PRINCIPLES OF HEMODIALYSIS
DIFFUSION
ULTRA
FILTRATION
OSMOSIS

6. PRINCIPLES OF HEMODIALYSIS
• Diffusion is the movement of particles from an area of greater
concentration to one of lesser concentration
• Osmosis is the movement of fluids across a semipermeable
membrane from an area of lesser concentration of particles to an
area of greater concentration of particles
• Ultrafiltration is the movement of fluid across a semipermeable
membrane as a result of an artificially created pressure gradient

7. METHODS OF VASCULAR ACCESS
Central Venous Catheter
AV Fistula
AV Graft

9. DIALYSIS CIRCUIT

10. NURSING CONSIDERATIONS
Pre-dialysis care
• Assess: Weight, Vital signs, Potassium level
• Review Medications
• Check access site
During Dialysis
• Watch for Hypotension, Muscle cramps, Nausea and vomiting,
Headache, Itching and hypersensitivity reactions.

11. Post Dialysis Care
• Monitor BP; report hypotension or hypertension
• Watch for bleeding
• Check weight and compare (weight loss should be close to
removal goal set during treatment)
• Document unusual findings
• Assess access site for bruit, thrill, exudate, signs of infection,
bleeding

12. COMPLICATIONS
RELATED TO VASCULAR ACCESS
INFECTION CATHETER CLOTTING STENOSIS OR
THROMBOSIS

13. COMPLICATIONS
RELATED TO VASCULAR ACCESS
ISCHEMIA ANEURYSM

14. COMPLICATIONS
RELATED TO MACHINE
AIR EMBOLISM BLOOD LOSSHEMOLYSIS

15. COMPLICATIONS
RELATED TO MACHINE
HYPO OR HYPERTHERMIA FLUID IMBALANCES