Maintenance Hemodialysis

About This Module

25 evidence reviews for physicians, advanced practice providers, fellows, and advanced learners who manage patients on in-center hemodialysis. Each page takes one clinical decision — the potassium bath, the target weight, the ultrafiltration rate, a high pre-dialysis blood pressure, the monthly labs — and works through the trials, the guideline positions, and the evidence gaps, with references linked to PubMed. Reviewed September 2026.

Every page ends with an At the chair box that links a printable dialysis nursing reference card. The complete screening and health maintenance white paper remains available as a single long read; Track 4 divides it into decision-sized pages.

Track 1 — The Hemodialysis Prescription

Choosing the dialysate: potassium, sodium, calcium, buffer, magnesium, and glucose.

Track 2 — Volume and Hemodynamics

Setting the target weight, keeping the ultrafiltration rate safe, and handling intradialytic hypotension.

Track 3 — Blood Pressure in Dialysis

Which reading to trust, how to treat, the intradialytic rise, and whether peridialytic BP belongs in a quality measure.

Track 4 — Monitoring and Preventive Care

The monthly and yearly work of chronic dialysis: cardiometabolic risk, CKD-MBD, infection and vaccines, cancer screening, adequacy, and anemia.

Track 5 — Nutrition, Inflammation, and Cardiovascular Prevention

Protein-energy wasting, inflammation and the PISCES fish-oil trial, and anticoagulation for atrial fibrillation.

Track 6 — Vascular Access Care

Examining and cannulating the fistula or graft, and caring for the catheter.

Full review: vascular access selection in older adults · Fistulas and worsening heart failure · Access nursing cards and PDFs

Track 7 — Missed Treatments and Health-Related Social Needs

Meet people where they are. Understand why coming to dialysis is difficult, match help to the barrier, and check whether the plan worked.

Vascular Access: Older Adults and Heart Failure

Shared access decisions, treatment burden, and the cardiac effects of fistulas and grafts. Two focused nursing cards, each with a printable two-sided PDF.

Monthly Labs and Quality Review: Focused Nursing Cards

Six separate cards for the questions behind the monthly dashboard. Each has a two-sided PDF and links to its complete evidence review.

Chair-Side Nursing Cards

Fourteen chair-side cards below, plus the six focused quality-review cards above. Twenty cards in all for dialysis nurses and technicians. The front says what to do, when to call the nephrologist, and what not to do; the back gives the reasons, with references. Each prints front and back on one sheet, and each has a PDF. The physician’s written order and the unit protocol always govern. Open the card index →

Complete White Paper and Related Pages

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