Dialysis Disequilibrium Syndrome and Infection Control: Essential Safety Tips for Dialysis Centers

Dialysis disequilibrium syndrome occurs most frequently within the first few dialysis sessions. It is thought to cause an acute increase in brain water for osmotic reasons because blood urea nitrogen (BUN) may be very high at the beginning of a dialysis session.

Some common symptoms are headache, nausea, vomiting, restlessness, and severe seizures may occur.

Mainly two reasons lead to DDS 

1. Reverse osmotic swift
2. Intra cerebral acidosis and idiogenic osmosis

The treatment is supporting and elevating dialysate glucose concentration to 200mg/dl can help Dialysis Disequilibrium syndrome, DDS can be prevented by keeping dialysis efficiency low during the first couple of treatment sessions. Increase dialysis efficiency slowly over the next 2-4 weeks to prevent DDS.

Manage DDS by

1. Reducing the blood flow rate of the machine
2. Reduce Ultra Filtration Rate(UFR)
3. A hypertonic solution like 3% sodium chloride can be administered, If symptoms persist, dialysis treatment should be terminated, and manage patient symptomatically.

How do we prevent and control infection in dialysis centers? 
 

Hemodialysis and peritoneal dialysis in a lifeline for ESRD patients. Dialysis patients are at high risk of infection because of underlying illness and numerous environmental and procedural illnesses.

Establishing a comprehensive infection control program for dialysis units will reduce the infection risk for patients and healthcare workers.

Universal Precaution to Avoid Infection in Dialysis Centres:

1. Healthcare staff must wear fluid-impermeable garments
2. Gloves must be changed and hand washed between aligning with patients
3. Protective eyewear and face shields are worn when connecting and discontinuation of dialysis sessions for staff and patients also.
4. No Re-use of Needles
5. Gloves are to be used whenever there is potential for blood or body fluids exposure.
6. Use PPE for more safety.
    

General Precaution for healthcare workers and patients:

1 .Surveillence for HBsAg.

2. Isolation of HBsAg and patients

3. Cleaning of dialysis machine and contaminated areas after dialysis.

4. Ensure the floor is clean after and before the dialysis session.

5. Dialyzer should not be reused for seropositive patients.

Exposure to blood:

1. Testing for HBsAg and HBsAb at the time of the incident and 6 weeks later.
2. Testing for HIV is required if exposed to blood
3. If any patient is seropositive, inform the patient and take steps to avoid infection in the Hemodialysis unit.
    

Vaccination is mandatory for dialysis patients. Influenza, Titeny diphtheria, pneumococcus, and HBsAg vaccine help patients fight against infection and build immunity for a happy and healthy life.

Neuroncy Healthcare is dedicated to preventing and stopping infection in healthcare and emphasizes the value of on-time, quality, value-based healthcare in Kolkata.