introduction
We all know that under normal physiological conditions, a healthy person's kidneys work 24 hours a day, never slacking off. With healthy kidneys, we can have urine, we can rely on urine to excrete metabolic wastes and toxins, regulate plasma osmolality, electrolytes and acid-base balance, and with healthy kidneys, we can maintain the stability of the body's internal environment and enable the body's organs to operate normally. There are 24 hours in a day, 7 days a week, and healthy kidneys work hard for our bodies 168 hours a week.
However, when kidney function is impaired or completely lost, these waste products and water can build up in the body, leading to serious conditions such as uremia. In order to sustain life, patients with renal failure require renal replacement therapy, of which hemodialysis is the most common and widely chosen modality.
So, why is hemodialysis the first choice, and why do you need three treatments a week?
1. Hemodialysis: the first choice for renal replacement therapy
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The technology is mature and widespread
Since the advent of hemodialysis in the 40s of the 20th century, after decades of development, the technology has been very mature. Globally, the number of haemodialysis centres, well-equipped and well-equipped healthcare professionals have made this treatment accessible to more people with kidney disease.
2. Applicable to a wide range of people
Whether it is acute kidney injury or chronic kidney failure, hemodialysis is an effective treatment. Especially for patients with chronic renal failure, hemodialysis can sustain their lives for a long time and improve their quality of life.
3. The treatment effect is remarkable
Hemodialysis can quickly remove metabolic waste, toxins and excess water from the body, correct electrolyte and acid-base balance disorders, thereby relieving patients' symptoms and prolonging survival.
4. Create conditions for other treatments
For patients waiting for kidney transplantation, hemodialysis can be used as a transitional treatment to create good physiological conditions for transplant surgery. In addition, hemodialysis can also provide a window of time and opportunities for other treatments such as medication, nutritional support, etc.
5. Medical insurance policy
Chronic renal failure is within the scope of the national chronic disease medical insurance, and it is one of the major diseases that the people can afford.
2. Why do I need hemodialysis 3 times a week?
The frequency of hemodialysis is determined based on a number of factors, such as the patient's kidney function, the severity of the disease, the physical condition, and the effectiveness of dialysis. Retrospective studies in China have proved that hemodialysis twice a week requires the premise of prolonging the duration of a single dialysis session and controlling the total weekly ultrafiltration volume to receive a better therapeutic effect. Recommended hemodialysis regimen: 3 times a week, 4~4.5 h each time (residual kidney GFR > 2mL / min / 1.73 m2, if hemodialysis is used twice a week, it is recommended to dialysis 5 ~ 5 per time. 5 h）。 The hemodialysis adequacy criteria set forth in this guideline apply to patients undergoing the hemodialysis regimen described above.
In general, three haemodialysis sessions a week are the most common arrangement for the following reasons:
1. Maintain a stable dialysis effect
During dialysis, waste and water are removed from the blood, but over time, these substances build up again in the body. The frequency of dialysis three times a week ensures that waste and water do not accumulate to dangerous levels between dialysis sessions, thus maintaining a consistent dialysis outcome.
2. Reduce the risk of complications
Inadequate dialysis can lead to serious complications such as uremia, hyperkalemia, and acidosis. Dialysis three times a week can reduce the risk of these complications and protect the patient's life.
3. Protect residual kidney function
For patients with residual partial renal function, dialysis three times a week can remove waste and water while giving the kidneys enough rest time, which is conducive to preserving residual renal function and delaying the progression of the disease.
4. Improve quality of life
Consistent dialysis results, a lower risk of complications, and better protection of residual renal function all contribute to a better quality of life. The frequency of dialysis three times a week allows patients to have more time and energy to devote to work, study and life in addition to treatment.
3. Why do I need to be treated for 4 hours each time?
1. The purge effect is time-dependent
Hemodialysis is a method of draining blood from the body to the outside of the body, passing through a dialyzer composed of countless hollow fibers, and the blood and the electrolyte solution containing similar concentrations of the body (dialysate) are exchanged inside and outside the hollow fibers through the principles of diffusion, ultrafiltration, adsorption and convection, removing metabolic wastes from the body and maintaining electrolytes and acid-base balance. Clearance is time-dependent, with too short a treatment time leading to inadequate clearance, and too long a treatment time potentially increasing the risk of complications. Therefore, a treatment time of 4 hours is considered to be a relatively balanced option that can reduce the risk of complications while ensuring clearance.
2. Patient tolerability considerations
Hemodialysis takes a certain amount of time and process, and the patient's physical condition and tolerance are also factors to consider. Excessive treatment time may cause fatigue, discomfort, or other complications. Therefore, the treatment time of 4 hours takes into account the patient's tolerability to some extent.
3. Clinical practice and research support
A large number of clinical practices and studies support 4 hours as the standard treatment time for hemodialysis. This time setting has been widely used in practice and has been well received with treatment results and patient feedback.
It is important to note that although 4 hours is the common duration of hemodialysis treatment, the specific treatment time may vary depending on the patient's specific situation, doctor's advice and dialysis method. Therefore, when receiving hemodialysis treatment, patients should actively cooperate with the doctor's treatment advice, maintain a good attitude and living habits, and work together to overcome the disease.
IV. Conclusion
As the preferred method of renal replacement therapy, hemodialysis has brought hope to countless patients with kidney disease due to its mature technology, wide range of applicable populations, remarkable treatment effects, and creating conditions for other treatments. The frequency of dialysis three times a week is based on a combination of factors to maintain stable dialysis results, reduce the risk of complications, preserve residual kidney function, and improve the quality of life of patients. For replacement therapy, only 12 hours of hemodialysis per week are used to replace 168 hours per week of work for the kidneys in a healthy state. Therefore, we strongly recommend, or follow the guidelines, for those who need renal replacement therapy, it is best to do it 3 times a week for 4 hours at a time.
For patients with high single ultrafiltration volume, poor blood pressure control, poor metabolic control, hyperphosphatemia, metabolic acidosis, and/or hyperkalemia, not only should be guaranteed 3 times a week for 4 hours at a time, but also should consider increasing the number of hemodialysis sessions or extending the duration of a single hemodialysis treatment.
However, it is important to note that each patient's specific situation may be different, so during the actual treatment process, the doctor will develop a personalized dialysis plan based on the patient's specific situation. Patients should actively cooperate with the doctor's treatment advice, maintain a good attitude and living habits, and work together to overcome the disease.