Nephrologist explains how the portable hemodialysis used by Faustão works

Presenter Fausto Silva, better known as Faustão, continues on hemodialysis treatment after undergoing a kidney transplant, carried out in April 2024 at Hospital Israelita Albert Einstein, in São Paulo. The presenter also underwent heart transplant surgery after severe heart failure.

Fausto has used a modern portable hemodialysis machine, which makes it possible to carry out sessions in his own home, without the need to travel to a specialized clinic or hospital.

Understand how the modern hemodialysis machine works

“The technology is very similar to that of the conventional machine. It is miniaturized, smaller, allowing dialysis to be carried out at home. But it promotes treatment with the same effectiveness”explained Pedro Túlio Rocha, nephrologist and coordinator of the Kidney Transplant Program at Hospital Adventista Silvestre, in Rio de Janeiro.

The first portable hemodialysis machine to be approved was the NxStage System One, and it is also one of the most used today. The machines are similar and weigh around 30kg, they can be taken home or on trips, eliminating the need to travel to places specialized in carrying out the procedure.

_{Hemodialysis machine for home care System One (Photo: reproduction/Medical Expo)}

It is necessary for a professional to undergo training in handling the machine for the patient and a caregiver, who may be a family member. The training consists of teaching how to change the cartridges used by the machine to filter blood, monitor vital signs, administer medications and how to act in the event of a medical emergency.

The machine's power source is through sockets and the session lasts two and a half hours with blood being pumped from the patient to the machine. The blood passes through the dialyzer, a membrane removes waste – large quantities of electrolytes and unwanted liquids – while maintaining important blood cells and proteins. In the last stage, the blood returns to the patient, in a continuous process.

Treatment data is sent to an application allowing download on a mobile device, providing ease for the doctor to access and monitor the patient without needing to be in the same environment.

The alternative brings practicality, however, it involves other issues, such as specialized and appropriate training, and also the responsibility of the patient and the care they are responsible for. The machine has a high price that can reach tens of thousands of reais, in addition to maintenance costs. Therefore, there are not many machines in use in Brazil.

“It is still little used, especially in Brazil, but more in the United States and Europe. And it grew a lot with the pandemic to eliminate the need for patients to travel to specialized centers” said the expert.

Understand what hemodialysis is all about

Hemodialysis is a treatment carried out in sessions that consists of cleaning and filtering the blood, eliminating substances that are harmful to health, such as excess salt and liquids. The kidneys are responsible for performing this function, in case of organ impairment, hemodialysis becomes the alternative, according to information from the Brazilian Society of Nephrology (SBN).

Depending on the patient's clinical status, the duration of the procedure sessions can vary from 3 to 5 per session, requiring a minimum of 2 days or even every day of the week. One of the objectives of kidney transplantation is to eliminate the patient from hemodialysis sessions.

Featured Photo: presenter Fausto Silva (Reproduction/O Globo)