The dialysis process clears metabolic waste and excess fluid from the blood when failing kidneys can no longer perform these functions. During each four-hour haemodialysis session, blood flows through sterile tubing into a specialised filter machine before returning cleansed to the body. Patients sit comfortably in a reclining chair, resting or reading while the system stabilises electrolytes.
What happens during a routine haemodialysis session?
For families in Ghaziabad navigating advanced chronic kidney disease, starting clinical therapy often brings anxiety about what happens in the chair. In the OPD, I explain to every newly diagnosed family that starting treatment restores physical energy by removing toxic urea and balancing blood acidity. During a routine session, trained technicians connect the patient's vascular access to the machine through two fine lines.
One line draws blood into the dialyser cartridge, where a semipermeable membrane filters out waste products against a sterile cleansing solution. The second line returns the cleaned blood back into the body. Blood pressure and oxygen levels are recorded every thirty minutes throughout the procedure. We cannot predict in advance exactly how much dry weight a patient will comfortably tolerate losing in their first week, so fluid removal is adjusted gradually across each sitting.
At the end of four hours, the machine returns the remaining blood in the circuit back into the patient before lines are disconnected. The access needles are gently withdrawn, and sterile pressure pads are applied over the puncture sites for twenty minutes to ensure complete haemostasis. Patients rest quietly in the chair until standing blood pressure confirms stability before walking out.
Why is an AV fistula created before long-term dialysis?
Long-term maintenance therapy requires a reliable vascular access that can handle rapid blood flow three times a week. A vascular surgeon creates an arteriovenous fistula (an AV fistula) by connecting an artery directly to a vein in the forearm or upper arm. Over six to eight weeks, the high pressure from the artery thickens the vein wall, creating a sturdy vessel that withstands repeated cannulation.
Whenever I examine an established access, I place my fingers over the vessel to feel the steady vibration, known as the thrill. Hearing a continuous swooshing sound with a stethoscope confirms healthy blood velocity through the circuit. If therapy must begin urgently before a fistula matures, a temporary soft catheter placed in the jugular or femoral vein provides immediate access.
What should patients watch for between dialysis sessions?
Life on maintenance therapy runs on a predictable rhythm (usually four hours three times a week). Between treatments, fluid and waste slowly rebuild in the tissues. I tell patients to weigh themselves each morning on the same bathroom scale to track fluid gains accurately. Gaining more than two kilograms between sessions strains the heart and makes fluid removal more uncomfortable during the next cycle.
Last month, a retired bank cashier from Ahinsa Khand II in Indirapuram arrived for his scheduled evaluation with severe leg swelling and shortness of breath. His family had skipped his mid-week session because of a festival gathering, believing that missing one afternoon would cause no harm. His fluid retention had accumulated rapidly over forty-eight hours, straining his breathing until we removed the excess volume through dialysis.
How does Healing Tree manage maintenance haemodialysis?
At Healing Tree Hospital, our department provides maintenance haemodialysis for daycare and admitted patients across a four-station unit. Dr. Manisha Dassi (MBBS, MD, DM (Nephrology)) evaluates kidney function during scheduled OPD hours between 12:30 pm and 1:30 pm, which patients confirm on WhatsApp before travelling. For patients preparing for long-term therapy, the team arranges AV fistula creation for long-term dialysis, with the vascular surgeon, alongside femoral and jugular catheter access.
When does a dialysis patient need immediate emergency care?
Between scheduled visits, sudden complications require immediate evaluation. Danger signs include severe breathlessness while lying flat, sudden chest tightness, high fever with chills during or after catheter use, bleeding from the access site that does not stop with ten minutes of firm pressure, or extreme muscle weakness. Do not wait for your next morning slot when these symptoms occur.
Go immediately to the emergency department at Healing Tree Hospital, located at Shakti Khand III in Indirapuram, Ghaziabad. The emergency desk is staffed twenty-four hours a day and can be reached at +91 92891 30163.
Following the prescribed fluid allowance and attending every scheduled cycle keeps life steady. This article is for educational purposes only and does not replace medical consultation or individual clinical assessment.