Renal - Renal Haemodialysis Non-attendance Advice

Introduction

This leaflet provides general information about your prescribed haemodialysis treatment. It aims to answer many of the questions you may have. It is not intended to replace the discussion between you and your doctor but may act as a starting point for discussion.

What does dialysis do and why is it so important?

Haemodialysis cleans the blood. It removes waste, salts, and extra water to prevent them from building up in the body. If you do not attend for dialysis you may feel.

• Tiredness
• Weakness
• Nausea or poor appetite
• Loss of body weight

Can there be any complications or risks?

If you do not complete your full dialysis time each session, you may feel “OK” but be at increased risk of hospital admission or even death.

The standard dialysis prescription is four hours of dialysis, three times per week (or 12 hours per week).

What will happen if I decide not to attend or shorten one of my prescribed haemodialysis sessions?

If you do not attend all your full dialysis sessions, you will be risking your health. You may encounter the following problems:

• High potassium levels which can affect your heart rhythm and can be life threatening
• Too much fluid in the body leading to fluid in your lungs, breathlessness, swollen ankles, raised blood pressure and heart failure
• Itching, feeling tired and exhausted
• Decreased appetite
• Increased risk of mortality

What if I decide not to attend my haemodialysis session?

If you do not plan to attend for a prescribed haemodialysis session, please contact your dialysis unit.

If you do not attend for a prescribed haemodialysis session and have not notified the unit, a dialysis nurse will ring you at home or on the number that we have recorded for you in your notes.

• We will then ask for an explanation for your non-attendance
• Explain to you why it is important for you to attend all prescribed sessions
• Check that you understand fully the risks and consequences of not attending for your dialysis session
• Inform your kidney consultant and your GP of your decision
• It will be recorded in your notes your wish not to attend for your treatment and the actions taken and advice given to you
• If we cannot contact you or a relative, and you have not been admitted to hospital, we may contact the police or ambulance service to check that you are safe and well
• When you next attend your dialysis session, we will re-discuss with you why you did not attend dialysis

If you do not attend your dialysis regularly, you make this choice at your own risk. Alternative session times are not always available and as a result you may lose your regular time and dialysis slot.

If after reading this you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Who should I contact if I want to discuss my dialysis?

You can either talk to your named dialysis nurse, coordinator, the dialysis unit manager, your GP or an appointment will be made to see your kidney consultant.

Who should I contact if I feel unwell?

Contact your GP or local Emergency Department, especially if you have missed more than one dialysis session. Do not wait until your next session if you feel unwell.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the:

Salford Renal Unit - 0161 206 5229

Bolton Kidney Care Centre - 0161 206 8364

Wigan Kidney Care Centre - 0161 206 4810

Oldham Kidney Care Centre - 0161 206 8441

Rochdale Renal Unit - 01706 906140

Please read the information leaflet. Share the information it contains with your family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you.