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1) Three times per week (12-15hours/week)
2) Dialysis staff is very friendly & patient feels comfortable & homely.
3) Patient knows well about diet, high in protein with adequate calories
4) Patient has good appetite and is ambulant (with exceptions)
5) Patient has a good concept of restricted fluid intake
6) With regular dialysis there is no edema (swelling) of legs & feet
7) Patient is not breathless and feels better after dialysis until next dialysis
8) There is no significant & frequent fall of B.P. during and after dialysis
9) Patient has no nausea or vomiting during and after dialysis
10) Patient has no depression (lethal) due to counseling, & cooperation by family
11) Room temperature should be comfortable (about 25° C) and there should not be continuous sharp lights disturbing the eyes of patients
12) Blood flow during dialysis is kept 300-400ml/min. generally, for adequate removal of waste products (with exceptions)
13) Formula of "Hemodialysis Concentrate" should be customized according to individual patient's clinical needs. 14. Concentrate must be of high quality to ensure quality of life and avoid complications as it flows against blood in the filter. Poor quality or non-compatible "Hemodialysis Concentrate" causes complications
14) Quality of RO water (120 litres flows against blood to clean it) should be according to International Standards(AAMI/BP) as regards pH, conductivity, salts, toxins & bacteria to avoid chronic complications. It needs regular management
15) Dialysis filter (dialyzer) should have a good quality membrane from a well-reputed company for good dialysis
16) Patient's Hemoglobin should be targeted to 12 gm/dl through EPO injections to avoid weakness/breathlessness. Blood transfusions should be avoided unless deemed very necessary. All patients should be regularly screened for Hepatitis and separate water system and machines should be used for Hepatitis-B patients
17) Dialyzer Reuse should be performed according to internationally recommended Protocol using high-Quality Sterilizing Solution to avoid serious complications
18) Hemodialysis machines flow system should be daily cleaned/sterilized using high-quality and well-established Chemical reagents
19) Powder form of "Hemodialysis Concentrate" should be fully dissolved in RO water until no powder remains at bottom (generally up to 30 minutes)