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What does the patient do during dialysis?
Treatment for hemodialysis usually takes place in a hemodialysis unit. This is a special building that is equipped with machines that perform the dialysis treatment. Special equipment adds the proper materials to purified water for the dialysis machines. The dialysis unit is also the place where patients can receive dietary counseling and help with social needs.
Patients generally go to the dialysis unit three times a week for treatment. For example, the schedule is either Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday. Before treatment, patients weigh themselves so that excess fluid accumulated since the last dialysis session can be measured. Patients then go to assigned chairs that are like lounge chairs. The area of the graft or fistula (the connection between the artery and vein), is cleaned thoroughly. Two needles are then inserted into the graft or fistula. One takes the blood to the machine where it is cleaned. The other needle allows blood that is returning to the patient to go back into the patient's body.
Treatments last from 2 ½ to 4 ½ hours. During this time, the dialysis staff checks the patient's blood pressure frequently and adjusts the dialysis machine to ensure that the proper amount of fluid is being removed from the patients body. Patients can read, watch television, sleep, or do other work during treatment. On occasion, patients who are very motivated may be able to perform dialysis themselves at home in a process called home hemodialysis.
Peritoneal dialysis requires the patient to play a more active role in their dialysis treatment. Of primary importance is the patient's responsibility for maintaining a clean surface on the abdomen and catheter, where treatment is administered, in order to prevent infection.
In this process, the patient weighs herself/himself to determine the fluid to be used. The patient then puts on a mask and cleans the peritoneal catheter site. Fluid that has been allowed to stay in the peritoneal cavity is drained back into the plastic bag that originally contained the fluid. The patient then disconnects this bag and connects a new bag of solution that is allowed to drain into the peritoneal cavity. Once the fluid is in the body, the new bag is rolled up and placed in the patient's underwear until the next treatment. This procedure usually takes 30 minutes to accomplish and must be done four to five times a day.
As an alternative to this treatment, some patients on peritoneal dialysis use a machine called a "cycler." This cycler is used every night. Five to six bags of dialysis fluid is used on the cycler and the machine automatically changes the fluid while the patient sleeps.