Dialysis 

The dialysis unit provides flexible twice-daily dialysis sessions for both inpatients and outpatients. The unit has special facilities for dialysis hepatitis B & C patients. Full cover is provided for the Intensive Care and LIver Units for Haemofiltration and Haemodiafiltration services. Dialysis for visiting overseas patients can also be arranged. Read some frequently asked questions given below to know more about Dialysis.

Hemodialysis Machine

Services

> Holiday Haemodialysis 
> Haemofiltration 
> Plasma exchanges 
> Continuous ambulatory peritoneal dialysis

Additional Information
24 Hrs emergency dialysis available

Charges
First Hemodialysis with new dialyzer = Rs.1500 per sitting
Subsequent Hemodialysis = Rs. 1000 per sitting

How doctors can refer patients
Please contact the department on 4225 5225

How to access the department 
Patients should be referred by their doctor

Dialysis removes fluid and wastes
The main purpose of dialysis is to help impaired renal function. When your kidneys are damaged, they are no longer able to remove wastes and excess fluid from your bloodstream efficiently. Waste such as nitrogen and Creatinine build up in the bloodstream. If you have been diagnosed with CKD, your doctor will have these levels carefully monitored. One of the best indicators of kidney function is your glomerular filtration rate (GFR). Your GFR tells your doctor how well your kidneys are filtering waste from your blood.
If your GFR level is below 15, dialysis becomes necessary. Before dialysis, patients often felt weak and ill. Dialysis brings relief from these symptoms. This is the primary benefit of dialysis.

Dialysis helps regulate electrolytes
Electrolytes are certain minerals the body needs to function correctly. They are important for our overall health. We get most of these minerals from the foods we eat. But too much or too little can make you sick. Healthy kidneys help control the levels of electrolytes by filtering the excess and keeping what is needed.
For patients with CKD, following their renal dietitian’s recommendations is an important aspect of regulating electrolytes. A renal diet provides good all-around nutrition while limiting proteins and certain minerals. Your dialysis session becomes more effective, and you will feel better as a result.

Dialysis can’t replace hormones
Your kidneys are part of the body’s endocrine system. The endocrine system controls certain body functions by making and releasing hormones into the bloodstream. When your kidneys are damaged, they may produce very little hormones or none at all. Unfortunately, dialysis cannot replace or manufacture these chemicals. These will need to be replaced in the body with medication.

Calcitriol helps your body absorb calcium
One of the hormones your kidneys produce is calcitriol. Calcitriol allows your body to absorb calcium from the foods you eat. Without it, your body would be unable to get enough calcium, even if you are taking calcium supplements. Calcium has many functions in the body. One of its main functions is keeping bones strong. A lack of calcium can make bones weak and brittle. Calcium is also important in maintaining a normal heartbeat and keeping your nerves and muscles functioning properly. If your kidneys are not producing enough calcitriol, your doctor may prescribe ZEMPLAR®.

Erythropoietin signals red blood cell production
Another hormone your kidneys produce is erythropoietin. Erythropoietin sends a chemical message to your bone marrow to make red blood cells. Red blood cells are the cells that transport needed oxygen throughout the body. Without adequate levels of oxygen, your body’s cells will not have the energy to do their jobs. If your red blood cell count is too low, you may develop anemia. Anemia will make you feel dizzy and weak, a sign that there is not enough oxygen making its way throughout your body. If you are anemic, your doctor will prescribe EPOGEN® or EPO be given to you during your dialysis treatment.

Renin helps regulate blood pressure
Renin is an enzyme your kidneys make. Its primary job is to regulate blood pressure. However, some patients with CKD produce too much renin. Excess renin can cause your blood pressure to rise. If you have already been diagnosed with high blood pressure, too much renin can elevate your pressure even more. High blood pressure is the second most common cause of CKD. It can also accelerate kidney damage. Your doctor may prescribe a medication to help lower your blood pressure.

Dialysis is the primary procedure used to treat patients in the later stages of chronic kidney disease. However, additional medicine may be needed to replace enzymes and hormones. It is important to follow your health care team’s recommendations regarding treatment. Your overall health depends on treating the lack of renal and endocrine functions of your kidneys.

FREQUENTLY ASKED QUESTIONS FOR DIALYSIS

What is dialysis?
Dialysis is a treatment for people in the later stage of chronic kidney disease (kidney failure). This treatment cleans the blood and removes wastes and excess water from the body. Normally, this work is done by healthy kidneys.
Sometimes dialysis is a temporary treatment. However, when the loss of kidney function is permanent (as in end-stage kidney failure), you must continue to have dialysis on a regular basis. The only other treatment for kidney failure is a kidney transplant.
There are two types of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, your blood is passed through an artificial kidney machine to clean it. Peritoneal dialysis uses a filtration process similar to hemodialysis, but the blood is cleaned inside your body rather than in a machine.

What is hemodialysis?
Hemodialysis means "cleaning the blood" - and that is exactly what this treatment does. Blood is circulated through a machine which contains a dialyzer (also called an artificial kidney). The dialyzer has two spaces separated by a thin membrane. Blood passes on one side of the membrane and dialysis fluid passes on the other. The wastes and excess water pass from the blood through the membrane into the dialysis fluid, which is then discarded. The cleaned blood is returned to your bloodstream.

How are you attached to the dialysis machine?
You can be attached to the dialysis machine in different ways. The most common method of providing permanent access to the bloodstream for hemodialysis is an internal fistula in your arm. This involves having an artery and a vein connected surgically. When they are joined, the stronger blood flow from the artery causes the vein to become larger. Needles can be inserted in the enlarged vein to connect you to the dialysis machine.
Another way to provide access to the bloodstream is to insert an internal graft. In this procedure an artery is surgically connected to a vein with a short piece of special tubing placed under the skin. Needles can be inserted in this graft.
Sometimes, when it is necessary to gain access to the bloodstream quickly, or when the veins in the arms are too small to provide enough blood for hemodialysis, a central venous catheter is used. A soft tube is surgically inserted into a large vein in the neck or near the collarbone. This method is usually temporary until a permanent access site is ready.

Does hemodialysis hurt?
Insertion of the needles causes pain, but only for a brief time. This can be difficult for some people. Occasionally nausea, muscle cramps or dizziness can occur due to the fast removal of extra water from your body, which may cause your blood pressure to drop.

How long does hemodialysis take?
Each hemodialysis treatment normally takes four to five hours, and usually three treatments a week are needed. More frequent, shorter treatments or longer treatments may be indicated for certain patients. Only a small amount of your blood is out of the body at one time. Therefore your blood must circulate through the machine many times before it is cleaned.

Where can hemodialysis be done?
Hemodialysis may be done in a hospital dialysis unit, in a clinic away from the hospital, in a self-care centre (with some assistance from the staff), or at home. Special training is needed for self-care or home hemodialysis.

What is home hemodialysis?
Many dialysis centres in Canada offer the option of training patients or their partners to carry out hemodialysis at home. The dialysis machine and necessary modifications to your home are provided by the hospital. While some home hemodialysis patients follow a standard schedule of four to five hours three days a week, some Canadian centres are also offering nocturnal home hemodialysis in which patients go on dialysis four to six nights a week for six to eight hours while they sleep. Nocturnal home hemodialysis greatly improves the removal of waste products from the body and has been found to improve well-being, allow for a more liberal diet and reduce the need for medications.

What type of dialysis treatment is best?
The type of dialysis treatment you receive depends on what is most appropriate for your particular needs. It may also depend on what is available in your community. Each type of dialysis has its strengths and limitations. Your healthcare team can provide information and support to help you understand all the options and answer any questions you or your family may have.

What about proper nutrition?
You will need to learn appropriate food choices to meet your nutritional needs and control the build-up of food wastes and water. Your dietitian will work with you to design an individual eating plan that is healthy and enjoyable. Medications and vitamins may also be prescribed.

What other changes are needed with hemodialysis?
You will need to plan your week around your hemodialysis schedule. You may have to take time off work or school before you start hemodialysis and when the treatments begin. However, once your health is more stable, you should be able to return to your normal activities. Depending on your energy level, you may have to make some adjustments in your work situation or limit your activities.

Is travel possible on hemodialysis?
There are dialysis units across Canada and in many parts of the world. They have suitable facilities for visitors who need hemodialysis treatment. However, it is necessary to plan several months in advance due to limited space and staff. Your dialysis unit and local Kidney Foundation office can provide more information and advise you about travel costs and arrangements.