Hemodialysis is a procedure of artificial blood purification from toxins and excess substances in cases where the kidneys completely or partially lose the ability to perform this function. The decision to start hemodialysis treatment usually depends on clinical symptoms and the results of laboratory tests.

Usually there is a question - at which creatinine to start dialysis? When a doctor determines that there is a need to start replacement therapy, he takes into account the individual characteristics of each patient, his medical history and other factors when making a decision. It is important not to delay if necessary, but to start dialysis treatment on time - it is proven to improve the quality of life.

Some indicators that may indicate the need to start dialysis:

• Creatinine and urea: Increased levels of creatinine and urea in the blood may indicate kidney failure.
• Azotemia: High levels of nitrogen in the blood, especially in the form of ammonia and urea.
• Hyperkalemia: An increased level of potassium in the blood, which can be dangerous for the cardiovascular system.
• Electrolyte imbalance: Large variations in the levels of electrolytes such as sodium and calcium.
• Symptoms of poisoning: The presence of symptoms such as vomiting, nausea, dizziness, anemia, edema and other signs of kidney damage.
• Decrease in physical activity: If the patient loses the ability to perform daily activities due to kidney failure.

Timely consultation at nephrologist at Diavita Institute will allow you to determine a clear plan of action, optimal approaches and methods of therapy.

Hemodialysis is the process of cleaning the blood from toxins and excess substances with the help of a special device that uses a membrane for filtration (dialyzer). So, how does hemodialysis take place - the main mechanism of hemodialysis includes the following stages:

• The patient usually sits or lies in a comfortable chair or bed.
• Vascular access is provided.
• The hemodialysis machine is individually adjusted to the needs of the patient. 
• Blood from the patient passes through a system of sterile tubes (mains) into a special sterile filter (dialyzer).
• In a dialyzer, blood passes through microscopic tubes made of a polymer membrane that filters toxins, excess water and other substances.
• Purified blood is returned to the patient's body.
• During the procedure, the medical staff monitors the indicators of important parameters, such as pressure, temperature and other physiological indicators.

For hemodialysis, the patient must have vascular access. It can be an arteriovenous fistula for hemodialysis, a vascular prosthesis, a central venous catheter.

• Arteriovenous fistula for hemodialysis is a connection between a vein and a human artery created by a surgical method. During the hemodialysis procedure, such a fistula for hemodialysis allows both the collection of blood for purification and the return of already purified blood through special fistula needles.
• A vascular prosthesis can be implanted in patients who cannot form a fistula from their own vessels. It is a small flexible polymer tube into which both needles are inserted during the hemodialysis procedure, thanks to which blood is taken and returned to the body.   
• A central venous catheter is a flexible plastic tube with two ends through which the patient's blood is drawn and returned to the body. The use of a catheter can be accompanied by a number of infectious complications, so strict adherence to the rules of catheter care is recommended.

Treatment with hemodialysis is usually carried out for 4 hours 3 times a week, for life or before changing the method of renal replacement therapy. Sometimes doctors can adjust the duration and frequency of hemodialysis depending on the patient's condition and the effectiveness of the procedure.

It is important to consider that hemodialysis is a long and regular process that helps maintain and improve the quality of life of patients with kidney failure.

As per the implementation of the Medical Guarantee Program in Ukraine, treatment of patients with chronic kidney disease by hemodialysis in our medical center can be provided FREE of charge. This means that hemodialysis in Kyiv is free for the patient! You only need to have a valid declaration with your family doctor. Treatment is also provided free of charge by the method of peritoneal dialysis.

For effective treatment of patients, Diavita Institute equipped with state-of-the-art medical equipment and uses advanced dialysis technologies, which have been golden standards of renal replacement therapy in developed economies for several years.

During treatment with hemodialysis sessions, we use hemodialysis machines certified by the American agency FDA. If there are medical indications, we have the opportunity to perform expanded hemodialysis - HDx.

We use high-flow dialyzers, including Revaclear type dialyzers, which truly impress with their performance! Such dialyzers have a number of advantages, as they provide high efficiency of hemodialysis with a smaller area of membrane contact with blood. Features of dialyzers reduce the risk of sodium overload during the filling of the line circuit, which provides greater safety for the patient. The high biocompatibility of the dialyzer membrane minimizes the risk of chronic microinflammation, which quite often accompanies hemodialysis patients when other dialyzers are used.

Patients with chronic kidney disease undergoing hemodialysis treatment at the Diavita Institute have a high quality of life. We achieve such results thanks to the application of an individual approach to treatment, providing adapted dialysis therapy for each of our patients.