I remember when I first started dialysis at the unit seven years ago that it was the first time I had been in a dialysis unit and as well as all the large different equipment, I found that many of the staff that were caring for me asked me questions that I did not understand. “Hi Helen, how are you today”? Then, “What’s your pump speed”? This seemed to happen regularly, and despite the blank look on my face, the nursing staff still didn’t seem to grasp I knew nothing what they were talking about. Questions like what’s your target weight, what’s your UF, bicarb. dialyser/kidney e.t.c. were common. Eventually, I either worked it out for myself or asked. Sometimes I used to say “I don’t know, look in my notes”
This is probably very unintentional on the part of the renal staff, it’s just that its automatic for staff to sometimes speak in medical jargon and probably not their intention to confuse patients. I myself have recently had my knuckles wrapped by the admin of another support group for using abbreviations and renal terminology. I forget that other patients are newly diagnosed and that being on home haemodialysis also has made me more empowered about my care, therefore I’m used to writing renal abbreviations and recording in renal terminology in my notes.
I think there is scope here for staff to be more aware of the patient’s transition into the renal world, as not all patients attend pre-dialysis clinics and have knowledge of renal speak. Although I was familiar with some medical terminology and jargon, renal had not been my speciality so I was clueless. So, for people with no medical background, it must be twice as confusing and daunting to be thrust into this world of another language.
Some Common Dialysis Abbreviations and Meanings
Dx = Dialysis. Depends on which N.H.S. trust. N.B. sometimes also used to abbreviate diagnosis.
B.P. = Blood pressure. This is the pressure exerted on the arterial blood vessel walls and should always be checked on the arm that is not going to have a fistula or has a fistula.
A.V.F. = Arteriovenous Fistula. This is an artery joined to a vein in the arm to create access for dialysis.
H.D.= Haemodialysis (standard)
H.D.F. = Haemodialysis Filtration. This is more common in Europe and research has shown it removes larger toxins and is better for your heart and bones.
T.W. = Target weight. This is what your weight should be without carrying excess fluid that your kidneys can no longer excrete. Therefore, the fluid remains in your blood system, increasing your weight. Any decreased/ increased weight due to muscle/body mass should be noted. It is clinically defined as the lowest weight a patient can tolerate without the development of symptoms between dialysis and of hypotension.
U.F. Goal = Ultrafiltration. The amount of excess fluid that is removed during dialysis that your kidneys can no longer remove. Excess fluid is removed by a pressure gradient across the membrane of the dialyser. Water is forced to move from the blood through the membrane and into the dialysate fluid. The U.F. is programmed into the machine. This will be your weight at the unit minus your T.W. + any drinks you have on treatment + the wash back of blood at the end of dialysis. (Usually between 300-360mls).
Pump speed = This is the rate the blood is pushed in and out of the the body into the dialyser. The higher the pump speed the faster the blood is “cleaned”. AVFs allow for higher speeds than a catheter access. The pump speed also depends on other factors and this is monitored by the nurses. The U.S. tend to use higher pump speeds than Europe and have shorter treatments. There is now overwhelming evidence that higher speeds put more “strain” on the heart and other organs.
Bicarb. = Bicarbonate. Healthy kidneys help neutralise the acid that occurs following metabolism and is then excreted by the kidneys. The bicarbonate on the machine helps return the levels of acid in the body to a near normal level. Basically it acts as a buffer combined with the Bicarb. that is also in the dialysis fluid.
The artificial “Kidney” = This the is where toxins and excess fluid pass across a semi permeable membrane to perform dialysis.
Washback = The blood is washed back at the end of dialysis to avoid causing further anaemia.
Postural hypotension = Blood pressure drops on standing.
Intradialytic weight gain = The fluid gained during dialysis. The more fluid gained between treatments, the more strain is put on the heart, blood vessels and other organs. This will increase tiredness and mobility problems. The more fluid needed to be removed during dialysis also puts strain on the cardiovascular system.
Every effort has been made by the author to ensure the information provided is accurate. Please always check with your renal team if unsure. Thank you.
