Kidney Health

Hemodialysis: A Life Saver for Kidney Disease

Summary & Participants

One of the most important lifesaving advances for kidney failure, dialysis, was invented during World War II, but not widely available until the 1960s. Today, thousands of kidney patients owe their survival to this process. Join our panelists as they focus on the benefits of hemodialysis.

Medically Reviewed On: June 19, 2008

Webcast Transcript

LEONARD STERN, MD: Hopefully. The fistula is created by the surgeon in preparation for starting dialysis. These fistulas take a long time to mature, so the optimum management of a patient would be to create the fistula perhaps six months to a year before the patient requires treatment so that the vein would grow in size and would become large enough. The requirement of the fistula is that two needles are placed into the fistula repeatedly. The patients refer to it as a lifeline. After the needles are placed in and then removed, the fistula is reusable. An ordinary vein, when you place a needle into an ordinary vein, it collapses. It's no longer usable.

The fistulas have problems, though. In older patients, which are the majority of people that start dialysis, their veins are not good enough to create a fistula. Then they have to resort to artificial graft material, which is called Gore-Tex graft material, and the surgeons place these in position between arteries and veins, and these tend to have a limited lifespan. There are technical problems with them. They clot off frequently. But they also represent one form of access.

A third type of access is used as a temporary catheter, generally placed by either a surgeon or a radiologist in a position under the collarbone. There, the intent is as a bridge, to wait until one of these more permanent access develops. These bridge catheters -- or PermCaths, as they're called, or Tessio catheters -- are designed to allow us to provide dialysis treatments as a substitute for the fistula.

LISA CLARK: Jai, once you have the system set up, whatever the blood access is going to be, how long does the procedure take to have your body go through a dialysis cycle?

JAI RADHAKRISHNAN, MD: On average, each patient stays for between three and four hours at a time three times a week indefinitely.

LISA CLARK: What is the procedure like for the patient? When they come in, what happens for them?

JAI RADHAKRISHNAN, MD: Well, initially it takes a while for the body to get used to the procedure, so what the patient would notice is the needle stick. This can be minimized by using a local anesthetic, but a lot of times the patients just get used to the procedure and they don't need the anesthetic. Secondly, if the patient is not in a good situation as far as the heart goes, a lot of people have heart failure. Blood pressure may drop during the treatment and you may feel nauseous or you may have cramps or you may feel lightheaded, and this is minimized because the patients are monitored very carefully, and if the nurses do notice there's a problem, they'll immediately produce the amount of fluid being removed.

LISA CLARK: Now, that's one of the benefits of the hemodialysis process. You're in a center where there are doctors and nurses available.

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