Hemodialysis (HD) is one of the most widely used acute dialysis modalities for patients experiencing sudden kidney failure. It involves circulating the patient’s blood through an external dialysis machine equipped with a synthetic semipermeable membrane known as a dialyzer. This process removes toxins, corrects electrolyte imbalances, and eliminates excess fluid efficiently. To perform HD, vascular access is established through a temporary catheter, usually inserted into a large central vein.
Acute hemodialysis is particularly effective in rapidly lowering dangerously high potassium levels, treating severe acidosis, and managing fluid overload in critically ill patients. It also clears medications or toxins during poisoning cases when specific antidotes are unavailable. The process typically lasts 3 to 4 hours per session and may be repeated depending on the patient’s condition.
One of the major advantages of HD is its high solute clearance rate. The dialysis machine precisely controls blood flow, dialysate composition, and ultrafiltration rate, ensuring efficient and predictable treatment outcomes. Additionally, modern machines offer advanced safety features such as real-time monitoring of pressures, temperature, and blood volume. This makes HD a reliable option in intensive care settings.
However, HD requires trained personnel, specialized equipment, and infrastructure, making it less accessible in remote or resource-limited settings. It may also cause rapid fluid and electrolyte shifts, which can lead to hypotension, cramps, nausea, headaches, and cardiac instability. These effects are particularly concerning in elderly patients or those with heart conditions.
Despite potential complications, acute hemodialysis remains a cornerstone of emergency renal replacement therapy. It provides quick metabolic correction and is well-suited for acute toxic ingestions and life-threatening biochemical derangements.
