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

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  • ______________________________________________________________________ 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