STANDARD TREATMENT GUIDELINES HAEMODIALYSIScl maintenance hemodialysis, ii) Personnel for hemodialysis

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India
STANDARD TREATMENT
GUIDELINES
HAEMODIALYSIS
Ministry of Health & Family Welfare
Govt. of India

STANDARD OF CARE FOR
MAINTAINANCE
HEMODIALYSIS IN INDIA
Developed By
INDIAN SOCIETY OF NEPHROLOGY

1.0 AUTHORS’DECLARATION
All the authors have no conflict of interest. The chapters were written at the request of Indian
Society of Nephrology. No remuneration was paid to the authors of the chapter. The chapters
were then given to Ms. Shachi Vyas, Medical Writer for converting the chapters into
standardized style without changing the original content.
Authors of this guideline were:
Sr. No Topic Author’s Signature& Date
1 Setting up of hemodialysis unit
for maintenance hemodialysis
Dr.Vijay Kher
Chairman
Deptt. of Nephrology &
Transplant Medicine
Medanta Kidney &
Urology Institute,
Medanta - The Medicity
Gurgaon,
Dr. Mohan Rajapurkar,
MD
Director, Postgraduate
Studies & Research,
Muljibhai Patel Urological
Hospital,
Nadiad
2 Personnel for hemodialysis unit
for maintenance hemodialysis
Dr. Abhijit Taraphder,
MD. DM
Chief Academics &
Research,
Senior Consultant,
Department of
Nephrology
Apollo Gleneagles
Hospital, Kolkata.
Dr. Dhananjay Ookalkar Consultant nephrologist
Ashwini Kidney & Dialysis
Centre,
Nagpur
3 Selection of Machine and
dialyser unit for maintenance
hemodialysis
Dr. Rajeev Annigeri
Consultant Nephrologist
Apollo Hospitals,
Chennai
4 Water treatment for hemodialysis
Dr. Mohan Rajapurkar, MD
Director, Postgraduate Studies & Research,
Muljibhai Patel Urological Hospital,
Nadiad
5 Vascular access
Dr. Valentine Lobo, MD.DNB.
KEM Hospital, Pune

6 Priming, connecting &
disconnecting dialyser
Dr. Amit Gupta
MD, DNB, FRCP
Professor of Nephrology,
SGPGIMS, Lucknow
7 Anti-coagulation in hemodialysis
Dr. Abhijit Taraphder,
MD. DM
Chief Academics &
Research,
Senior Consultant,
Department of
Nephrology
Apollo Gleneagles
Hospital, Kolkata.
Dr. Dhananjay Ookalkar Consultant nephrologist
Ashwini Kidney & Dialysis
Centre,
Nagpur
8 Dialyser reuse (Manual &
automated)
Dr. Valentine Lobo, MD.DNB.
KEM Hospital, Pune
9 Dialysis dose/Adequacy
Dr. Vijay Kher
Chairman
Deptt. of Nephrology & Transplant Medicine
Medanta Kidney & Urology Institute, Medanta -
The Medicity
Gurgaon
10 Prevention of infections in
hemodialysis Unit
Dr. Vivekand Jha,MD,
DM
Secretary ISN
Additional Professor of
Nephrology
Postgraduate Institute of
Medical Education and
Research
Chandigarh
Dr. Amit Gupta
MD, DNB, FRCP
SGPGIMS, Lucknow
11 Emergency services
Dr. Ravi Raju
President, ISN
Director of Medical Education

Government of Andra Pradesh
Hyderabad
12 Laboratory back up
Dr. Ravi Raju
President, ISN
Director of Medical Education
Government of Andra Pradesh
Hyderabad
13 Nutrition
Dr Anita Saxena
PhD,PhD(Cantab)
Assistant Professor Nephrology,
SGPGIMS, Lucknow
14 CVD Monitoring & therapy
Dr. Mohan Rajapurkar, MD.
Director, Postgraduate Studies & Research,
Muljibhai Patel Urological Hospital,
Nadiad
15 MBD monitoring & Therapy
Dr.Vivekand Jha, MD, DM
Secretary ISN
Additional Professor of Nephrology
Postgraduate Institute of Medical Education and
Research
Chandigarh
16 Hypertension monitoring &
Therapy
Dr. Vijay Kher
Chairman
Deptt. of Nephrology & Transplant Medicine
Medanta Kidney & Urology Institute, Medanta -
The Medicity
Gurgaon,
17 Diabetes monitoring & therapy
Dr. Amit Gupta
MD, DNB, FRCP
SGPGIMS, Lucknow
18 Renal replacement in Intensive
care setting
_________________
Dr. Valentine Lobo,

Dr. Rajeev Annigeri
Apollo Hospitals,
Chennai
MD.DNB.
KEM Hospital, Pune
Please send feedback to mmrajapurkar@mpuh.org, with a copy to vjha@pginephro.org
mailto:mmrajapurkar@mpuh.org

2.0 TABLE OF CONTENTS
Contents
Title Page…………………………………………………………………………………………1
1.0 AUTHORS’DECLARATION .................................................................................................. 3
2.0 TABLE OF CONTENTS .......................................................................................................... 7
3.0 LIST OF ABBREVIATIONS ................................................................................................... 8
4.0 INTRODUCTION .................................................................................................................. 11
5.0SETTING UP OF HEMODIALYSIS UNIT FOR MAINTENANCE HEMODIALYSIS ..... 13
6.0 PERSONNEL FOR HEMODIALYSIS UNIT FOR MAINTENANCE HEMODIALYSIS . 17
7.0 SELECTION OF MACHINE AND DIALYSER UNIT FOR MAINTENANCE
HEMODIALYSIS......................................................................................................................... 24
8.0 WATER TREATMENT FOR HEMODIALYSIS ................................................................. 36
9.0 VASCULAR ACCESS ........................................................................................................... 44
10.0 PRIMING, CONNECTING AND DISCONNECTING DIALYSER ............................... 51
11. ANTICOAGULATION IN HAEMODIALYSIS ................................................................... 55
12. DIALYSER REUSE (MANUAL & AUTOMATED) ......................................................... 60
13. DIALYSIS DOSE/ADEQUACY ...................................................................................... 68
14. PREVENTION OF INFECTIONS IN HEMODIALYSIS UNIT ..................................... 71
SCHEDULE I-CATEGORIES OF BIO-MEDICAL WASTE ................................................. 80
SCHEDULE II- COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF
BIO-MEDICAL WASTES ....................................................................................................... 82
SCHEDULE III- LABEL FOR BIO-MEDICAL WASTE CONTAINERS/BAGS ................. 83
15. EMERGENCY SERVICES .................................................................................................... 85
16. LABORATORY BACKUP .................................................................................................... 88
17. NUTRITION ........................................................................................................................... 96
18. CVD MONITORING & THERAPY .................................. Error! Bookmark not defined.
19. MBD MONITORING & THERAPY ................................................................................... 114
20. HYPERTENSION & THERAPY ......................................................................................... 118
21. DIABETES MONITORING & THERAPY ......................................................................... 123
22. RENAL REPLACEMENT IN INTENSIVE CARE SETTING ........................................... 126

3.0 LIST OF ABBREVIAT