Dialysis Centre

• Consultations for chronic kidney disease
• Prevention and monitoring of kidney diseases
• Prevention of kidney stones
• Treatment of high blood pressure
• Kidney-related complications during pregnancy
• Pre- and post-kidney transplant follow-up
• Nephrogenetics
• ‘Pre-dialysis’ consultations with nursing follow-up

Néphrologues

• Dr Charlotte VAN NOTEN - Head of Department
• Dr Marie-Carmen MUNIZ-MARTINEZ
• Dr Hussein RAHAL
• Dr Anke VAN MELLAERT

Nephrologists

• Dr Charlotte VAN NOTEN - Head of Department
• Dr Hussein RAHAL

Nephrologists

• Dr Marie-Carmen MUNIZ-MARTINEZ, sometimes replaced by:
  • Dr Charlotte VAN NOTEN
  • Dr Anke VAN MELLAERT

The Role of Healthy Kidneys

Excess water and waste products are eliminated by the kidneys and expelled through urine.

But the kidneys also have other very important functions:

• Maintaining the body’s electrolyte balance (such as potassium and sodium).
• Producing hormones that regulate blood pressure (renin), stimulate red blood cell production (erythropoietin), and preserve bone strength (vitamin D).

Kidney Failure

Chronic kidney disease reflects impaired kidney function, regardless of the cause (diabetes, high blood pressure, recurrent kidney infections, hereditary kidney diseases, etc.).

Your nephrologist will work closely with you during consultations to slow the progression of the disease through a specific diet and medications, in close collaboration with your primary care physician.

This process can take several weeks or even several years.

When the kidneys function less and less, they can no longer carry out the functions necessary for life. Excess water may accumulate, causing swelling (edema) or shortness of breath.

The production of certain hormones decreases, and you may start to feel unwell because the accumulation of waste can cause, in addition to electrolyte imbalances, loss of appetite, altered taste, nausea, itching, fatigue, and concentration problems.

This stage is known as end-stage renal disease. At this point, it becomes necessary to start a replacement dialysis technique (hemodialysis, peritoneal dialysis) or to be eligible for a kidney transplant.

Hemodialysis is the process of cleansing the blood using a dialyzer, an artificial membrane.

This dialyzer is part of a dialysis machine (or generator).

Approximately 300 ml of blood flows through the dialyzer every minute via tubing and the dialysis filter. This typically occurs during three weekly sessions, each lasting about 4 hours.

A special vascular access is required for this technique.

Types of Vascular Access

1.Arteriovenous Fistula (AVF)

An AVF is created under local anesthesia by connecting an artery to a nearby vein. It takes about 6 weeks before it can be used, which is why planning it before starting dialysis is important.

Care instructions:

• Regularly monitor the fistula’s function (pulse, thrill, etc.).
• Protect it during physical activities or manual tasks.
• Avoid taking blood pressure, drawing blood, or inserting IVs in the fistula arm.

2.Jugular Catheter (CVC)

If an AVF is unavailable or not yet usable, dialysis is performed using a catheter.

A dialysis catheter is a flexible device inserted into a jugular vein at the base of the neck.

• Placement is done under local anesthesia in the radiology suite and takes about 30 minutes.
• Rarely, it may be placed in an operating room.
• The catheter can be used immediately and remains in place between sessions, without the need for needles.

Care instructions:

• Keep the dressing dry; waterproof dressings allow showering before dialysis sessions.
• Maintain cleanliness and secure placement; the dressing is changed once a week by dialysis staff.

What Happens During a Session

• Your dialysis schedule will be planned together with the team.
• If you need transportation, our secretary or social service can contact a transport company; part of the cost may be covered by your insurance.
• Arrive at the scheduled time—punctuality is required.
• A charter will be given at arrival, and you will wait in the waiting area until called.
• You will be asked to weigh yourself.
• You will then be seated and connected to the dialysis machine via your fistula or catheter.
• During the session, your vital signs are monitored. You can read, watch TV, listen to music, or chat with neighbors. Internet access is available upon request.
• At the end, your blood pressure will be checked. If all is well, you can weigh yourself and report your exit weight.

Practical Information

Clothing

• Wear dialysis-friendly clothing: loose sleeves and easy access to the catheter (button-up shirt/blouse; avoid turtlenecks).
• Keep the same type of clothing for every session.

Facilities

• Lockers and TVs with personal headphones are provided.
• Schedule changes require nephrologist approval and depend on service organization. Please respect your arrival time.

Nutrition

• Following your prescribed diet is an important part of treatment.
• Daily fluid intake: 500 ml in addition to your daily urine output.
• If you no longer urinate, total fluid intake (including soup) is limited to 700 ml per day.
• Monitor salt, potassium, and phosphorus intake.
• A nutritional brochure is provided; a dietitian is available upon request.

Did you know ?

At CHIREC, the dialysis department has been treating patients with hemodialysis for many years using hemodiafiltration.

This method is highlighted in the following scientific article. Learn about its benefits: https://www.nejm.org/doi/full/10.1056/NEJMoa2304820

Peritoneal dialysis is a cleansing method performed inside the abdomen using a natural membrane called the peritoneum.

This peritoneal membrane acts as a filter to cleanse the blood and remove excess water from the body.

Peritoneal dialysis can be done at home after training at the hospital. The procedure can be performed by the patient themselves or by a caregiver (family member or home nurse).

To perform peritoneal dialysis, a small-diameter intra-abdominal catheter (flexible tube) must be surgically inserted under general anesthesia.

A hospital stay of about 48 hours is required for this minor surgical procedure.

The catheter remains in place for as long as the patient continues peritoneal dialysis.

How It Works

A dialysis solution is introduced into the peritoneal cavity via the catheter.

• The solution stays in the cavity for several hours—this is called the dwell time.
• After the dwell time, the solution is drained and replaced with a fresh dialysis solution.

This process is called an exchange and is generally repeated four times per day. Each exchange lasts about 30 minutes.

Types of Peritoneal Dialysis

1. Manual Peritoneal Dialysis (Daytime)

• Usually involves four exchanges per day, performed during the daytime.

2. Automated Peritoneal Dialysis (Nighttime)

• Performed at night using a machine called a cycler.
• Typically, 8 to 10 hours of treatment per night are prescribed, depending on your clinical condition and lab results.

The choice of treatment depends primarily on your lifestyle, health status, and dialysis needs.

Practical Information

• Peritoneal dialysis is performed 7 days a week, making it a gentler treatment because excess water and waste are continuously removed from the body.
• Medical and paramedical teams will teach you how to perform exchanges during about one week of training at the hospital.
• A home visit is arranged before catheter placement to ensure, for example, that you have a storage area for supplies (about 2 m³ per month).
• A specialized company delivers the dialysis products.
• Between manual exchanges, you are free to carry out your daily activities.
• For automated nighttime dialysis, patients are free during the day.

Regular consultations are necessary (every 4–6 weeks) to ensure everything is going smoothly.

Your Responsibilities :

• Between sessions, you are responsible for:
• Monitoring your weight and blood pressure
• Inspecting your catheter
• Maintaining a clean environment during exchanges

Some patients choose home hemodialysis after undergoing several weeks of training in the outpatient dialysis unit.

This choice is made by the patient, based on their desire to take full responsibility for their treatment and to receive care in their family environment. Home hemodialysis offers freedom and flexibility as it allows for the scheduling, frequency, and duration of dialysis sessions to be adjusted. The only requirement is to respect the minimum of 12 hours of dialysis spread relatively evenly throughout the week.

New, compact, and easy-to-use monitors make this technique safely feasible at home. These devices allow for short daily treatments (2 hours or 2 hours and 30 minutes), ensuring a more physiological therapy that is better tolerated by the patient.

Daily hemodialysis easily integrates into your daily life and offers a significant advantage in terms of quality of life and independence.

In addition to these 2 hours of treatment, you will be responsible for :

Preparing your machine (about 40 minutes)

Managing your vascular access (catheter or fistula)

Managing your supplies (ordering and receiving deliveries every 2 weeks or monthly), and waste disposal (sorting).

Assistance from a home nurse is possible.

A home visit is required before the start of your training to ensure that you have enough storage space and all the necessary conditions to ensure the safety of your treatment.

A kidney transplant is a surgical procedure (performed in a university hospital) requiring general anesthesia. The donor kidney (graft) is implanted in the recipient’s abdomen, while the diseased kidneys are usually left in place.

Pre-Transplant Evaluation

A pre-transplant workup is required, including cardiac, digestive, respiratory, and other assessments.

Based on the results, the doctor evaluates whether you are a suitable candidate for transplantation. If so, you are placed on the transplant waiting list.

Finding a compatible donor kidney can take varying amounts of time. Living donor candidates may also be considered.

Post-Transplant Treatment

After transplantation, you must take anti-rejection medication to prevent your body from rejecting the graft.

These immunosuppressive drugs may have side effects, such as:

• Reduced immunity against infections
• Weight gain
• High blood pressure

However, taking these medications daily is critically important for the survival of the transplant.

Follow-Up

Regular medical follow-up is essential, as a kidney transplant is a treatment rather than a cure for kidney failure.

In the event of transplant rejection, returning to dialysis is always possible.

Dialysis treatments are fully covered by social security.

However, some costs remain your responsibility, such as medications and part of your transportation expenses.

It is not recommended to drive after a hemodialysis session. Transportation services can be arranged if needed.

That said, kidney failure treatments can require adjustments in your social and professional life. You can share your feelings and emotions with a psychologist or with others who have had similar experiences.

After an adaptation period, it is essential to resume your daily activities and regain your independence.

Dialysis should not be a barrier to continuing your studies, traveling, or engaging in physical activities.

Please inform us as early as possible if you plan to travel so we can organize your follow-up care.

The dialysis process may require you to readjust your life plans, but…

WE ARE HERE TO HELP YOU!

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• @email
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We will get back to you as soon as possible.