Maintenance hemodialysis is a long-term treatment approach used for patients with end-stage renal disease (ESRD) whose kidneys can no longer effectively filter toxins, excess fluid, and waste products from the blood. This therapy acts as an artificial replacement for kidney function and is typically performed several times a week on a regular schedule. During hemodialysis, the patient’s blood is circulated through a dialysis machine, which contains a specialized filter called a dialyzer. The dialyzer performs the vital task of cleaning the blood by removing toxins such as urea and creatinine, correcting electrolyte imbalances, and managing fluid overload. Once the filtration process is complete, the purified blood is safely returned to the patient’s body, helping maintain overall metabolic balance.
The process of maintenance hemodialysis requires vascular access, which is usually created through an arteriovenous (AV) fistula, AV graft, or a central venous catheter in some cases. AV fistulas are considered the best option because they provide long-term durability and lower risk of infection. Each dialysis session typically lasts around four hours, and most patients require three sessions per week. The exact treatment duration and frequency depend on individual health conditions, kidney function levels, fluid status, and metabolic needs.
Maintenance hemodialysis plays a crucial role in improving the quality of life for patients with chronic kidney failure. It helps regulate blood pressure, maintain appropriate electrolyte levels, prevent fluid overload, reduce symptoms such as fatigue and nausea, and support overall well-being. However, it is not a cure; it is an ongoing therapy that requires strict adherence to the schedule. Along with dialysis sessions, patients are advised to follow specific dietary restrictions, including limited fluid intake, controlled consumption of potassium and phosphate, and adequate protein intake. Medications may also be required to manage anemia, mineral bone disease, and blood pressure.
Regular monitoring by nephrologists, dialysis technicians, and dietitians forms an essential part of maintenance hemodialysis care. Patients undergo periodic blood tests to assess treatment effectiveness and adjust dialysis settings or dietary plans accordingly. Emotional and psychological support is also important, as dialysis can significantly impact daily routines and lifestyle. Despite these challenges, maintenance hemodialysis enables patients to lead relatively stable and functional lives while awaiting kidney transplantation or continuing long-term renal replacement therapy.
