• Reference Number: HEY870/2024
• Departments: Renal Service
• Last Updated: 31 December 2024

Introduction

This leaflet has been produced to give you general information about your prescribed haemodialysis treatment. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What does dialysis do and why is it so important?

Like healthy kidneys, haemodialysis cleans the blood. It removes waste, salts and extra water to prevent them from building up in the body. It keeps a safe level of certain salts in your blood, such as potassium, sodium and bicarbonate.

The dialysis prescription provides instructions the nurse needs to carry out in order to make sure that enough water and waste products are being cleaned from the blood.

The symptoms you may feel if you do not get enough dialysis include:

• tiredness
• weakness
• nausea or poor appetite
• loss of body weight

Can there be any complications or risks?

If you do not complete your full dialysis time each session, you may feel “OK” but be at increased risk of hospital admission or even death.

For a dialysis patient, getting the right amount of dialysis will usually make that person feel better and help lead a more active and healthy life.

The standard dialysis prescription is four hours of dialysis, three times per week (or 12 hours per week).

Studies have shown that patients having a good dialysis do much better in the long term and usually live longer than those having inadequate dialysis.

What will happen if I decide not to attend or shorten one of my prescribed haemodialysis sessions?

If you do not attend all your full dialysis sessions you will be risking your health. You may encounter the following problems:

• High potassium levels which can affect your heart rhythm and can be life threatening.
• Too much fluid in the body leading to fluid in your lungs, breathlessness, swollen ankles, raised blood pressure and heart failure.
• Itching, feeling tired and exhausted.
• Decreased appetite

What if I decide not to attend my haemodialysis session?

If you do not attend for a prescribed haemodialysis session a dialysis nurse will ring you at home or on the number that we have recorded for you in your notes.

• We will then ask for an explanation for your non attendance
• Explain to you why it is important for you to attend all prescribed sessions
• Check that you understand fully the risks and possible consequences of not attending for your dialysis session.
• Inform your kidney consultant and your GP of your decision.
• It will be recorded in your notes your wish not to attend for your treatment and the actions taken and advice given to you.
• If we cannot contact you or a relative, and you have not been admitted to hospital, we may contact the police or ambulance service to check that you are safe and well.
• When you next attend your dialysis session, we will re-discuss with you why you did not attend dialysis.

If you do not attend your dialysis regularly, you make this choice at your own risk. Alternative session times are not always available and as a result you may lose your regular time and dialysis slot.

Who should I contact if I want to discuss my dialysis?

You can either talk to your named dialysis nurse, team leader, the dialysis unit manager, your GP or an appointment will be made to see your kidney consultant.

Who should I contact if I feel unwell?

Contact your GP or local Emergency Department, especially if you have missed more than one dialysis session.  Do not wait until your next session if you feel unwell.

Under the Data Protection Act (1998) we are responsible for maintaining the confidentiality of any information we hold about you.  For further information visit:

https://www.hey.nhs.uk/privacy/data-protection/

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the:

Hull Dialysis Unit on                     tel: 01482 608758

Scunthorpe Dialysis Unit on       tel: 03033 306220

Bridlington Dialysis Unit on       tel: 01262 408070

Grimsby Dialysis Unit on             tel: 01472 279950

Please read the information leaflet. Share the information it contains with your family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.