Pediatric Nephrology Clinical Services : Conditions & Procedures

Hemodialysis

In hemodialysis, the child’s blood is sent through a filter to remove harmful wastes, extra salt and extra water. Hemodialysis helps control blood pressure and keep the proper balance of potassium, sodium, calcium and bicarbonate.

Hemodialysis uses a special filter called a dialyzer. During treatment, blood travels from the child’s body through tubes into the dialyzer, which filters out wastes and extra water. Then the cleaned blood flows through another set of tubes back into the child’s body. The dialyzer is connected to a machine that monitors blood flow and disposes of the wastes.

Hemodialysis usually takes place in a clinic or hospital three times a week, but it may be required more often in smaller children. Each treatment lasts from 3 to 4 hours. Some clinics offer home hemodialysis, which allows more flexibility in scheduling but requires the caregiver to take weeks of training. During treatment, the child can do homework, read, write, sleep, talk or watch TV.
If you choose hemodialysis, the doctor will need to create an access to the bloodstream (vascular access) several months before the first treatment. The child may be able to complete the procedure for the vascular access in one day or may need to stay overnight in the hospital.

When a child starts hemodialysis, problems can be caused by rapid changes in the body’s water and chemical balance during treatment. Muscle cramps and a sudden drop in blood pressure are two common side effects. Low blood pressure, called hypotension, can make a child feel weak, dizzy or nauseated.

Most children need a few months to adjust to hemodialysis. Side effects can often be treated quickly and easily, so you should always report them to your doctor and dialysis staff. You can avoid many side effects by making sure your child gets a proper diet, limits liquid intake, and takes all medicines as directed.