During the hemodialysis treatment process, vascular access options, how sessions are applied, nutritional considerations, and possible complications are frequently wondered by patients and their relatives. In this article, you can find answers to frequently asked questions, from the advantages of hemodialysis to the treatment process, from daily life considerations to nutritional recommendations.

What Is Hemodialysis?

The question "What does hemodialysis mean?" is one of the most commonly asked questions among the public. Hemodialysis is a treatment method applied when the kidneys are unable to adequately filter harmful substances and excess fluid that accumulate in the blood. Through this treatment, substances that build up in the body and may adversely affect health are removed from the blood with the help of a special device. This treatment supports some of the functions that the kidneys would normally perform and helps maintain the body's internal balance.

What Are the Advantages of Hemodialysis?

The purpose of hemodialysis is to support the healthy functioning of the body and to reduce problems that may arise due to kidney failure. It provides several advantages toward this goal. The advantages of hemodialysis are as follows:

Removal of harmful substances accumulating in the blood: When the kidneys are not working sufficiently, waste products such as urea and creatinine accumulate in the body. Hemodialysis helps cleanse these substances from the blood.
Balancing excess fluid: Excess fluid accumulated in the body can cause edema, shortness of breath, and high blood pressure. Hemodialysis ensures the controlled removal of excess fluid.
Maintaining electrolyte balance: It helps keep minerals such as potassium, sodium, and phosphorus in balance, supporting the preservation of heart and muscle functions.
Aiming to improve quality of life: It contributes to the reduction of complaints such as fatigue, nausea, loss of appetite, and shortness of breath, helping daily activities to be carried out more comfortably.

Through Which Vein Is Hemodialysis Performed?

To perform hemodialysis treatment, safe access to the blood is required. For this purpose, different vascular access methods may be used depending on the patient's condition. Your doctor will decide which method is appropriate. These methods are as follows:

Fistula

The most commonly preferred method.
A connection line is surgically created by joining arm veins.
Suitable for long-term use.

Points to Pay Attention To:

Blood pressure should not be measured from the arm with the fistula, and blood should not be drawn from it.
The fistula should be checked daily to see if it is functioning by feeling for a vibration (thrill) with your hand.
Heavy objects should not be lifted with the arm containing the fistula.
Watches, bracelets, or tight jewelry should not be worn on the arm with the fistula.

Graft

Used in cases where a fistula cannot be created due to vascular structure.
Created with the help of an artificial vein.

Temporary or Permanent Catheter

Preferred in emergencies or when a fistula/graft is not ready.
Usually placed in the neck or chest area; it is important to keep the catheter caps closed during care and follow-ups.

It should be remembered that the type of vascular access and treatment duration may vary depending on the patient's overall condition.

What Is the Hemodialysis Treatment Process?

The hemodialysis treatment process and points to consider are as follows:

Before the Hemodialysis Session

Before a hemodialysis session, the patient's general condition is assessed. During this assessment:

Body weight is measured; similar clothing should be preferred for accurate results.
Blood pressure and pulse are checked.
The vascular access (fistula, graft, or catheter) is checked; loose and comfortable clothing that allows easy access to your vascular access should be worn.
Blood samples may be taken if deemed necessary.

During Hemodialysis

During hemodialysis, blood is taken from the body with the help of a special device, filtered, and returned to the body. During this process:

Your blood is cleansed of harmful substances.
Excess fluid is removed in a controlled manner.
During the session, you can sit, lie down, read a book, or rest.

Session Duration and Frequency

The duration and weekly frequency of hemodialysis sessions are determined by your doctor based on your needs. Generally:

Sessions are applied several days a week.
Each session may last approximately 4 hours.

Your treatment plan may be rearranged over time according to your weight changes, blood test results, and overall health status. You will be informed about this adjustment.

What May Be Felt During and After the Session

Some individuals may experience temporary complaints during or after hemodialysis. These complaints include:

Weakness or fatigue
Dizziness
Muscle cramps
Mild nausea

These conditions do not occur in everyone and often resolve temporarily and quickly.

Arm pain in the arm with a fistula or graft is an unexpected situation; if you feel pain, you should inform the healthcare team so that necessary measures can be taken.

After dialysis, especially during the initial period of treatment, you may feel tired. Therefore, it is recommended that you plan your return home after the first sessions in advance and, if possible, arrange for support.

What Are the Nutritional Recommendations in Hemodialysis Treatment?

Hemodialysis treatment can affect how the body utilizes and balances nutrients. Therefore, it is important that the nutrition plan is tailored to the individual. Your doctor and/or dietitian will create the most appropriate nutrition plan for you.

Approach to Protein Consumption

Protein contributes to the body's self-renewal and the continuation of daily activities. Protein needs may vary from person to person during the hemodialysis process.
Quality protein sources such as meat, chicken, fish, legumes, and eggs may be included in the nutrition plan. Processed meat products such as salami and sausages, however, are recommended to be consumed as limited as possible.

Regulating Fluid Intake

Fluid balance is an important part of hemodialysis treatment. Daily fluid needs may vary from person to person and are determined by your doctor.
Weight gain between dialysis sessions may indicate fluid accumulation in the body. Therefore, keeping fluid intake within recommended limits helps the treatment proceed safely.

*Maximum weight gain between dialysis sessions should generally be limited to 1.5–2 kg.

Approach to Salt (Sodium) Consumption

Salt consumption can increase water retention in the body and may lead to high blood pressure. Balancing salt intake is important during the hemodialysis process.
Reducing the use of salt in meals and limiting the consumption of ready-made, packaged foods can contribute to maintaining fluid balance.

Approach to Potassium Balance

Potassium is a mineral essential for the body; however, elevated levels can affect heart rhythm. Maintaining potassium balance is important during the hemodialysis process.
The consumption of some foods high in potassium content, such as bananas, oranges, potatoes, and tomatoes, may be restricted based on blood values. Blood potassium levels are monitored at regular intervals.

Approach to Phosphorus Balance

Maintaining phosphorus balance is important for bone and vascular health. Phosphorus levels are closely monitored during the hemodialysis process.
The consumption of milk and dairy products, as well as processed foods high in phosphorus content, may be restricted. If phosphorus-binding medications are prescribed by your doctor, it is important to use them regularly.

Approach to Vitamin and Mineral Supplements

The need for certain vitamins and minerals may change during the hemodialysis process.
It should be remembered that vitamin and mineral supplements should only be used upon the recommendation of a doctor or dietitian.

What Are the Complications of Hemodialysis?

If any of the following conditions occur during or after hemodialysis, it is important to contact the healthcare team for your safety:

Severe dizziness or fainting
Shortness of breath
Chest pain
Uncontrollable bleeding
Severe and persistent muscle cramps
Sudden pain in the vascular access area
Redness
Swelling or discharge
Rapid weight gain and significant edema

What Can Be Done When Side Effects of Hemodialysis Are Noticed?

What to do when the following symptoms are noticed at home:

Severe Dizziness or Fainting: May develop due to sudden low blood pressure or fluid imbalance. If it does not improve despite sitting or lying down, the healthcare team should be contacted.
Shortness of Breath: May occur due to fluid accumulation in the body or heart-lung overload. If it does not pass with rest, emergency evaluation is required.
Chest Pain: May suggest a serious condition related to the heart. Seek medical attention without delay.
Uncontrollable Bleeding: Continuous bleeding from the fistula or catheter site requires emergency intervention. Apply pressure with a clean cloth and seek medical attention as soon as possible.
Severe and Persistent Muscle Cramps: May be related to fluid or electrolyte imbalance. If the complaint persists, the healthcare team should be informed.
Sudden Pain, Redness, Swelling, or Discharge in the Vascular Access Area: May indicate infection or vascular access problems. Notify the dialysis team without delay.
Rapid Weight Gain and Significant Edema: May indicate fluid retention in the body. It is recommended to contact the healthcare team for evaluation of the dialysis plan.

What Precautions Can Be Taken Against Hemodialysis Complications?

During hemodialysis treatment, infection risk and falls due to dizziness may occur. Therefore, paying attention to the following points helps ensure the treatment proceeds safely. Some precautions for hemodialysis complications you can take include:

Since hemodialysis treatment may affect the immune system's response to infections, protection against infections is important. In this context, attention should be paid to hand hygiene, the vascular access used during dialysis should be kept clean, and the healthcare team should be informed if signs of infection such as fever or chills are noticed.
If you have symptoms of a cold, flu, or similar infection, it is recommended to wear a mask during the dialysis session. This practice helps reduce the risk of transmitting infection to others.
Dizziness or a feeling of imbalance may occur during or after hemodialysis. This can increase the risk of falls. It is recommended to use non-slip footwear, and to stand up slowly and in a controlled manner. It is important to ask the healthcare team for support when you do not feel well.
Individuals receiving hemodialysis treatment can continue their daily lives when necessary precautions are taken. It is important to pay attention to hygiene, rest, and protection against infections in the home environment.
Keeping the home environment clean and tidy helps reduce the risk of infection. Special attention should be paid to washing hands after dialysis and following personal hygiene rules. The vascular access area should be kept clean and dry.
Keeping pets is generally not harmful. However, it is important to pay attention to hand hygiene after contact with animals and to ensure that the vascular access area does not come into contact with animals.
It is recommended that pets receive their vaccinations regularly and that their general care is not neglected.
Fatigue may be felt after dialysis. You can continue your daily activities when you feel well and take time to rest when needed. It is recommended to avoid activities that require excessive exertion.
Maintaining social life is important. However, caution should be exercised against infection risk in crowded and enclosed spaces, and you should prefer to rest during periods when you do not feel well.