Role of Nephrologist( kidney specialist) in Hemodialysis.
Like other medicines that need dose modification in different patients, hemodialysis has to be modified according to the requirement of each patient. Although hemodialysis is done by a highly sophisticated machine operated by a trained technician, but it is your kidney specialist who will give instructions for the duration, type of dialysate and type of hemodialyzer.
The Nephrologist also estimates the amount of excessive fluid accumulated in the body and advises the amount and rate of its removal during dialysis. Sometime the patient does not feel well during or after dialysis because of the incorrect adjustment of the parameters.
He may complain of weakness after the dialysis due to excessive fluid removal, or becomes short of breath shortly after dialysis because of inadequate fluid removal. Dialysis is only one part of the treatment of the End Stage Kidney Disease to remove waste products, excessive salts and water from the body and to correct acidosis.
ESRD patients also develop other problems like anemia, high blood pressure and bone weakness, and each of these problem needs specific treatment. Not only your Nephrologist will advise the correct dose of the dialysis but he also adjusts the doses of the other medicines like drugs for hypertension, drugs for anemia (Erythropoitin, iron and folic acid supplements) and drugs for proper mineralization of the bones like calcium salts and vitamin D derivatives.