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OVERVIEW

When an end-stage renal failure occurs (i.e, when the kidney function is irreversibly reduced to below 15% of normal), there are two treatment options: dialysis or a kidney transplant (also known as a renal transplant). There are two types of dialysis: haemodialysis and peritoneal dialysis. This page deals with haemodialysis.

The word ‘haemo’ refers to blood. Haemodialysis is a process that balances blood chemistry and filters wastes and fluid from the blood.

For haemodialysis, two needles are inserted into the patient’s arm. One needle withdraws the blood and the other returns the filtered blood to the patient’s body.

The blood, which is withdrawn by the first needle, travels outside the body through the tubing and the dialysis machine then pumps this blood through a filter called a dialyzer, which is attached to the dialysis machine. The dialyzer cleans the blood and it is returned to the patient’s body through the other needle.

The dialyzer is also called an artificial kidney because it is an artificial replacement for the patient’s damaged kidneys. During the process of haemodialysis, the haemodialysis machine circulates the dialysate (fluid with chemicals that helps to remove wastes from the body) to the artificial kidney. Haemodialysis is typically performed at a dialysis center.

Equipment

Haemodialysis is performed at NU Hospitals with sophisticated equipment (volumetric, bicarbonate machines). We have 14 state-of-the-art machines [13 of them in the haemodialysis unit and 1 in the intensive care unit (ICU)]. A state-of-the-art reverse osmosis plant purifies the water used for haemodialysis. Periodic cultures of the reverse osmosis water are performed to ensure good quality of water.

The facilities at the Dialysis unit include:

  • State-of-the-art Fresenius haemodialysis machines with individual stations
  • Single-use dialyzer and tubing for every patient. This helps to minimize and prevent infections. We do not reuse the dialyzers.
  • Specialized Plex RO (Reverse Osmosis) pipelines, imported from Germany
  • Advanced and state-of-the-art Fresenius RO Plant for the better quality of RO water – very few centers in India have the same.
  • TDMS (Therapy Data Management System) monitoring, where a doctor can view the data of patients undergoing hemodialysis live and issue instructions to the dialysis team from anywhere in the world. This includes arterial and venous pressure, rotating speed of the blood pump, temperature and dialysate composition. The machine also calculates and controls the amount of fluid removed from the body.
  • Special dialysis couches at each individual station
  • Individual television unit for each dialysis station with all HD channels
  • Smart card for each patient that contains patient demographic data
  • Daily monitoring and audit of patients and machines.
  • Fully furnished and air-conditioned surroundings
  • Personal and Individual attention by senior doctors and round-the-clock team members
  • Specialized training and practice for dialysis team members to carry out cannulations in OT and on mannequins.
  • Hand hygiene surveillance monitored by CCTV and standardized active Infection Control Practices
  • Strict adherence to medical protocol and hospital best practices
  • Daily monitoring of safety practices
  • There are dedicated machines and space for HBsAg and HCV positive patients

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