How to lower the risk of infection in hemodialysis
Hemodialysis has a greater risk of infection than abdominal dialysis. Every machine that you use has had someone else's blood going through it. Additionally, people on dialysis usually have a weakened immune system and are more susceptible to germ invasion. There are two sources of infection: cross contamination from other patients with infectious disease like hepatitis and AIDS and bacterial and/or viral invasion at the point of needle insertion. There have been many outbreaks of hepatitis among hemodialysis patients reported by the Centers for Disease Control and Prevention. One possible explanation is that the dialysis centers have so many patients that nurses and technicians don't have the time to do a proper disinfection between treatments. You or your loved one have a right to insist on complete disinfection and discarding of all used disposable components before hooking up. If you have any doubts, stop the process, call the supervisor, and complain.
Regarding needle insertion, the silastic tube under the skin, while quite innovative, is not perfect. The nurse has to avoid sticking the needle in the same spot more than once. At some point this becomes less likely, and leaks are liable to occur, causing blood clots to form under the skin. With the patient's immune system in depression, the clot and the leaky tube usually become infected with rapid spread into the bloodstream. The best way to prevent this scenario is for the nurse or technician not to inject the needle into a previous needle mark. Once the needle marks become too numerous to avoid that, it is time for the nephrologist to change the A-V tube. Again, it is up to you to maintain the high standard of quality to which you are entitled. You cannot rely on the system of doctors, nurses, and administrators, because they are simply too busy to be so meticulous.