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Hemodialysis Discharge Instructions


About this topic


Hemodialysis filters your blood and takes out harmful substances. It takes over the work of your kidney. It removes extra water, wastes, and chemicals from your body. This type of dialysis uses a machine. Your blood is pumped into a filtering set-up to clean it. ‚  


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What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Keep the access site clean and dry.
  • Clean the skin around the access site each day:
    • Wash your hands before cleaning your access site.
    • Use a soap that kills germs or an antiseptic solution.
    • Do not remove any scabs or crusts.
    • Take extra care if you have a special tube for access. Hold the tube during cleaning to keep it from being pulled out. Talk to your doctor about what kind of dressing you need to use. Tape the tube to your body so it does not pull.
    • Use a clean cotton-tip swab to put on the ointment or cream that your doctor gives you.
  • Put plastic wrap over the dressing when you shower and make sure it does not get soaked. Gently towel-dry the part around the access site.
  • You may be taught to check your own blood pressure. Do not put the blood pressure cuff on the arm with your access site.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits. Your doctor may order blood tests during these visits.
  • Weigh yourself at the same time each day and on the same scale. Keep a record of your weight.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Control your blood pressure
  • Protect your bones and blood
  • Remove excess fluid from your body
  • Keep you from having hard stools
  • Help your body make more blood cells
  • Prevent infection

Will physical activity be limited?


  • Limit lifting heavy objects and heavy activities after getting a catheter or fistula.
  • You can go back to work and be active. Talk to your doctor about the right amount of activity for you.
  • Try not to go to crowded places where your access site can easily be bumped.

What changes to diet are needed?


Your doctor will have you meet with a dietitian to help you plan your meals. You may need to: ‚  
  • Eat foods rich in calories and protein
  • Stay away from food high in water, potassium, phosphorus, and sodium or salt
  • Talk to your dietician about other food choices If you are diabetic

What problems could happen?


  • Bleeding
  • Infection
  • Itching
  • Low red blood cells
  • Low blood pressure
  • Irregular heartbeat
  • Upset stomach and throwing up
  • Poor tolerance of dialysis. This may get better as you get used to it.

When do I need to call the doctor?


  • Signs of a very bad reaction. These include bluish skin; redness, warmth, pain, and swelling near the catheter site; dizziness and weakness. Go to the ER right away.
  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher; chills; catheter site will not heal; redness, warmth, pain, and yellowish, greenish, or bloody discharge from the catheter site; foul smell coming from the site.
  • Signs that your catheter or fistula is not working

Helpful tips


  • Wear loose clothing that will not rub on your access site.
  • Wear an arm guard or protective clothing when doing sports if your access site is on your arm.
  • When traveling, choose a place with a dialysis center near in case of emergency.
  • Choose a water bottle with markings to measure the amount you are drinking.
  • Join a support group to help you cope with your condition.

Teach Back: Helping You Understand


The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚  
  • I can tell you about my condition.
  • I can tell you how to care for my dialysis site.
  • I can tell you what I will do if I have swelling, redness, or warmth around my catheter site.

Where can I learn more?


National Kidney and Urologic Diseases Information Clearinghouse ‚  
http://kidney.niddk.nih.gov/kudiseases/pubs/vascularaccess/index.aspx ‚  
National Kidney Foundation ‚  
http://www.kidney.org/atoz/content/dialysisinfo.cfm ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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