Indications
Haemodialysis solution (dialysis fluid or dialysate) is used during haemodialysis, a treatment that cleans the blood when the kidneys can no longer do this job. It is used for people with kidney failure, either long-term (chronic kidney disease needing regular dialysis) or sudden (acute kidney injury), and sometimes to remove certain poisons or correct severe salt and fluid imbalances.
How It Works
The solution contains purified water with carefully balanced amounts of salts such as sodium, potassium, calcium, magnesium and chloride, plus a buffer (acetate or bicarbonate) and sometimes glucose. During dialysis, the patient’s blood flows on one side of a thin membrane inside the dialyser and the solution flows on the other side. Waste products such as urea and creatinine, extra potassium and other substances move from the blood into the solution, while the buffer helps correct acid build-up in the blood.
Dosage and Administration
This solution is never swallowed or injected directly. It is used only in a dialysis machine by trained dialysis staff. The type of solution, the flow rate, the length of each session and how often dialysis is done are decided by the kidney specialist (nephrologist) for each patient. Concentrated solutions are diluted with treated water by the machine according to the manufacturer’s instructions.
Interactions
Dialysis can remove some medicines from the blood, so the doctor may change the dose or timing of certain antibiotics and other drugs on dialysis days. Potassium and calcium levels in the solution can affect people taking Digoxin, so their blood levels are watched closely. Tell the dialysis team about every medicine you take.
Contraindications
The solution should not be used if it is cloudy, discoloured, leaking or past its expiry date. A specific formula may not be suitable when its potassium, calcium or buffer content does not match the patient’s needs; the doctor chooses the right one.
Side Effects
Problems seen during or after dialysis can include low blood pressure, muscle cramps, nausea, headache, tiredness and itching. Changes in blood potassium, calcium or sodium can occur if the solution does not suit the patient.
Tell the dialysis staff at once if you feel faint, have chest pain, a fast or irregular heartbeat, breathlessness, fever with shivering, confusion or fits during or after a session.
Pregnancy and Lactation
Dialysis can be continued in pregnancy and during breastfeeding when needed, usually with more frequent or longer sessions planned by the kidney specialist. Pregnant women on dialysis need close shared care with an obstetrician.
Precautions and Warnings
Only purified water that meets dialysis standards must be used, as contaminated water can cause serious reactions and infection. Blood pressure, weight, and blood levels of salts are checked regularly. Patients should follow the fluid and diet advice given by their dialysis team.
Overdose
Using the wrong solution or wrong settings can cause dangerous changes in blood salts or fluid. This is handled at once by the dialysis team, who stop or adjust the treatment and correct the balance.
Therapeutic Class
Haemodialysis solution (renal replacement therapy fluid).
Storage
Store as directed on the pack, usually below 30°C in a clean, dry place away from direct sunlight. Do not freeze. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.