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

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

STANDARD OF CARE FOR

MAINTAINANCE

HEMODIALYSIS IN INDIA

Developed By

INDIAN SOCIETY OF NEPHROLOGY

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

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.

Consultant Nephrologist

KEM Hospital, Pune

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

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.

Consultant Nephrologist

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

Professor of Nephrology,

SGPGIMS, Lucknow

11 Emergency services

Dr. Ravi Raju

President, ISN

Director of Medical Education

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

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

Professor of Nephrology,

SGPGIMS, Lucknow

18 Renal replacement in Intensive

care setting

_________________

Dr. Valentine Lobo,

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

Dr. Rajeev Annigeri

Consultant Nephrologist

Apollo Hospitals,

Chennai

MD.DNB.

Consultant Nephrologist

KEM Hospital, Pune

Please send feedback to mmrajapurkar@mpuh.org, with a copy to vjha@pginephro.org

mailto:mmrajapurkar@mpuh.org

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

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

______________________________________________________________________ Guidelines for Maintenance Hemodialysis in India

3.0 LIST OF ABBREVIAT