How long does it usually take to be hospitalized for the first hemodialysis

The hospitalization time for first-time hemodialysis patients is usually 1-2 weeks, depending on the stability of the condition, control of complications, and preparation for home care.

1. Disease assessment:

Patients with renal failure need to first assess the severity of uremia. If the blood creatinine value exceeds 707 μ mol/L or severe edema or heart failure occurs, emergency dialysis is required. In the early stage of hospitalization, daily monitoring of electrolyte, blood pressure and other indicators is required to adjust the dialysis plan.

2. Establishment of dialysis pathway:

Temporary jugular vein catheterization requires hospitalization for 3-5 days to observe the risk of infection, while arteriovenous fistula surgery requires hospitalization for 7-10 days, and postoperative ultrasound examination of fistula maturity is required. During hospitalization, nurses will guide patients to protect the fistula and avoid compression or lifting heavy objects.

3. Complications management: About 30% of patients may experience imbalance syndrome during their first dialysis session, manifested as headache or vomiting, which requires hospitalization and intravenous injection of mannitol for relief. Patients with hyperkalemia need to undergo continuous hemodialysis for 3 days in combination with potassium lowering resin treatment.

4. Operation training:

Family training will begin on the 4th to 5th day of hospitalization, learning techniques such as catheter disinfection and blood pressure monitoring. Third tier hospitals usually provide simulated dialysis machine operation teaching to ensure that patients master the daily limit of 500ml for diet and water control and medication time.

5. Arrangement of transition period:

After the condition is stable, it can be transferred to outpatient dialysis, but patients with diabetes need to be hospitalized for 3-5 days to adjust insulin dosage. Parathyroid hormone examination should be completed before discharge to prevent renal bone disease. After discharge, hemodialysis patients need to be equipped with an electronic scale to record daily weight changes and control weight gain during the two dialysis intervals to not exceed 5% of dry weight. Family members should learn to recognize emergency symptoms such as muscle spasms and low blood pressure, and prepare high sugar foods to cope with hypoglycemic episodes. Low phosphorus foods such as winter melon and egg whites can be consumed during the dialysis period, while high potassium foods such as bananas and nuts should be avoided. Regularly check hemoglobin and ferritin levels, and adjust the dosage of erythropoietin in a timely manner.