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Hemodialysis Center

Hemodialysis Center, Thainakarin Hospital provides hemodialysis service for patients with chronic renal failure at last stage and patients with acute renal failure.

Service/Diagnosis/Treatment

Patients will be closely monitored by experienced nephrologists and nurses according to the standards of the Association of Thai Interventional Neuroradiology. The center has shared rooms and private rooms with friendly environment. We offer services to the general public, government officials and patients holding social security benefits who have chronic renal failure. Patients having social security benefits can reimburse the hemodialysis from social security fund.

Service/Diagnosis/Treatment

  • On-line Hemodiafilltration
  • Hemodialysis

Diseases and Symptom –

Suggestions for patients and relatives for maintenance of permanent vascular access

What is the vascular access?

            Vascular access for hemodialysis is the path through which blood is brought from the patient’s body to the filter and cleaned blood will be brought into the patient’s body. There are two types of vascular access which are central venous access catheter and permanent vascular access surgery.

Maintenance of central venous access catheter or plastic access for hemodialysis

  • Maintain cleanliness, do not touch the wound or remove dressing.
  • Do not let the wound wet.
  • If the wound peels off or gets wet, visit the hospital to treat the wound again.
  • Do not wear o-neck t-shirts to prevent vascular access from being stuck.
  • Meet the physician in case of abnormalities e.g. the removal of vascular access, cold, shivering, pain, edema, or bleeding from the wound.

 

 

Patients with Permanent Catheter

  1. Arteriovenous fistula by using the patient’s coronary artery is the best method as hemodialysis can be performed with few complications and it has a longer useful life. However, we have to wait until the coronary artery is complete prior to operation (2-3 months).
  2. Arteriovenous graft will be performed if the patient’s coronary artery is too small. Arteriovenous graft will be inserted under the skin and can be used within 2-4 weeks. If it is well-maintained, its useful life will be prolonged for many years.

Self-care for patients receiving permanent catheter

  1. Post-surgery period
  • During the first 3 days, patients should raise their arms on which the surgery was performed at the heart level to prevent and relieve edema.
  • Patients can start exercising vascular access 3 days after the surgery, in case of no wound pain or serious bleeding, by fully squeezing a rubber ball (count 1 – 10) and release it. Do this several times a day, 10 – 15 minutes each round.
  • Do not let the wound get wet for 7 – 14 days or until stitches are off.
  • Avoid touching or hitting at the surgical parts.
  • Do not measure pressure, draw blood or give blood or IV fluids on the arm receiving surgery.
  • Do not use the arm attached with the vascular access to lift heavy things and avoid using sharp objects.
  • The patients who are prescribed antibiotics after the surgery should take all medicines as prescribed to prevent drug resistance.
  • Do not touch dirty things which may cause infection. Wash hands with soap after using toilet.
  1. During operation
  • Do not wear a wrist watch or bracelet. Do not wear any shirt that ties the arm receiving surgery for vascular access. Do not put your head on the arm on which the hemodialysis is performed. Do not lift heavy materials.
  • Clean the arm on which the hemodialysis is performed with soap and wipe with dry cloth before performing hemodialysis.
  • Examine by touching (vibration) and hearing (sound) at the vascular access area at least once a day. If there is no vibration or less vibration, consult the physician immediately.
  • Do not rub the skin near the vascular access.
  • Exercise the vascular access by fully squeezing a rubber ball (count 1 – 10) and release it. Do this several times a day, 10 – 15 minutes each round (Do not do it within the first 24 hours after operation).
  • Do not measure pressure, draw blood or give blood or IV fluids on the arm receiving surgery.
  • Avoid touching sharp objects. Avoid staying near extreme hot and cold things.
  • Notice numbness at hand and foot tip or darker finger tips and inform the nurse if such symptom is seen.