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HOW DO YOU TREAT CKD?
There are four ways to treat CKD: peritoneal dialysis, hemodialysis, transplant, or medical management.
What is hemodialysis?
Hemodialysis is a procedure in which a dialysis machine and filter (dialyzer) is used to clean your blood outside of your body. Blood flows through a sterile tubing to the dialyzer and continuously filters before it returns to your bloodstream. Only a small amount of blood is outside of your body at one time. Hemodialysis is often done at a dialysis center, and can also be done at home with a care partner.
How is blood retrieved for hemodialysis?
Reliable vascular access is required for blood to get from your body to the dialysis machine:
Arteriovenous fistula
Arteriovenous graft
Central venous catheter
What is AN arteriovenous fistula?
An arteriovenous fistula (AVF) is a surgical connection, made by a vascular surgeon, of an artery to a vein. This is the best choice of access for most people because there are no foreign materials needed. An AV fistula needs to be created months in advance prior to start of dialysis because it takes time to mature to the point that it can support dialysis.
Image from https://www.azuravascularcare.com/medical-services/dialysis-access-management/av-fistula-creation/
What is ARTERIOVENOUS GRAFT?
An arteriovenous graft (AVG) is similar to an AV fistula, but a composite material is used to connect an artery to a vein. An AV graft is needed if a surgeon determines that a natural connection cannot be made. Vessels may be unsuitable or too small for connection - this is determined on vein mapping by a vascular surgeon. Compared to the AV fistula, the AV graft can be used sooner after surgery, but there is higher risk of clotting off and higher risk of infection.
What is a central venous catheter?
A central venous catheter (CVC) is a thin, flexible tube that is inserted into a vein in your neck and threaded to your heart. This is the last option and used when all other vascular options (fistula, graft) have been exhausted, but can be useful in emergency situations, i.e. when dialysis needs to be started unexpectedly. CVC has a higher risk of infection and clotting.
What are the pros and cons of hemodialysis?
Pros:
Does not require daily sessions (you have “off-days.”)
You can travel, regardless of type of dialysis
In-person access to your care team
No limitations on swimming/bathing unless you have a CVC
No abdominal girth increase
Cons:
Diet and fluid limitations may be more restrictive than with PD.
Needle placement
Set schedule/appointment time
Side effects may be more likely because of the nature of the intermittent schedule/shorter treatment duration compared to PD. May increase the likelihood of cramps, nausea, fatigue.
Can I travel while on hemodialysis?
Yes! But it requires planning. For hemodialysis, you will be required to make a reservation at a dialysis facility nearby your travel destination. The staff at your “home” dialysis facility can help arrange this.
What does a hemodialysis schedule look like?
A typical in-center hemodialysis schedule is three days a week: Monday, Wednesday, Friday OR Tuesday, Thursday, Saturday.
Each dialysis treatment will take approximately 4 hours.
What support will i have with Hemodialysis?
Like peritoneal dialysis, you will have access to a robust team to help with your care. This includes a dedicated physician (nephrologist), advanced practice provider (physician assistant or nurse practitioner), hemodialysis nurse, patient care technician (PCT), dietician, and social worker.
HOW CAN INTERMED CONSULTANTS HELP YOU THROUGH YOUR KIDNEY CARE?
InterMed Consultants has been providing renowned kidney care in the Minneapolis area, as well as greater Minnesota, since 1979. From diagnosis to treatment, we provide extensive care for all of your CKD needs, including slowing down the progression of CKD, addressing additional problems associated with CKD, and educating patients and preparing them for all treatment options.
For more information or to schedule an appointment, please contact us (952) 920-2070.