Dialysis is a medical procedure intended to mimic kidney function in patients suffering from renal failure. When the kidneys are unable to adequately remove waste materials, extra fluid, and poisons from the blood, this process takes place.
Types of Dialysis
Two primary forms of dialysis exist:
1. Hemodialysis
When the kidneys can no longer adequately filter waste materials, extra fluid, and toxins from the blood, hemodialysis is one form of dialysis treatment used to address these conditions. A dialyzer, often known as an artificial kidney, is a specialised filter that is used in conjunction with a dialysis equipment.
How Hemodialysis Works
1. Bloodstream Access
- An arteriovenous (AV) fistula is a surgically created opening, typically in the arm, that connects a vein and an artery to facilitate easy access to dialysis and enhanced blood flow.
- An AV graft is an artificial tube placed beneath the skin to join an artery and a vein in a patient whose veins are unsuitable for a fistula.
- A central venous catheter is a tube that is usually used for temporary or emergency access and is placed into a major vein in the neck, chest, or groyne.
2. Blood Flow
Using an access point (catheter, graft, or fistula), blood is extracted from the patient and fed through the dialysis machine.
3. Procedure for Filtration
After the blood enters the dialyzer, it passes through tiny, hollow fibres composed of a membrane that is semi-permeable. Dialysate, the dialysis solution, circulates around these fibres. While vital components like proteins and blood cells stay in the circulation, waste materials and extra fluid from the blood flow through the membrane and into the dialysate.
4. Clear Blood Reprieved
Through the access site, the filtered blood is subsequently reintroduced into the body.
Hemodialysis’s Constituent Parts
- Dialyzer: Filters blood by functioning as a prosthetic kidney.
- Dialysate: A solution that enables the blood’s necessary substances be added while removing undesirable substances.
- Dialysis machine: Regulates blood and dialysate flow, keeps an eye on the procedure, guarantees effectiveness and safety.
Procedure Specifics
- Frequency: Usually three times a week, for three to five hours a session.
- Location: With the right equipment and training, home hemodialysis can be carried out at a dialysis facility or at your residence.
Benefits
- Effective Waste Removal: The body may effectively rid itself of extra fluid and pollutants.
- Improved Symptoms: Assists in reducing the weariness, edoema, and dyspnea associated with kidney failure.
- Quality of Life: Enables patients to continue living a life that is largely normal in spite of renal disease.
Potential Side Effects and Risks
- Hypotension: A decrease in blood pressure while receiving therapy.
- Muscle cramps: Changes in hydration and electrolyte levels can cause this.
- Infections: At the point of access, especially when using catheters.
- Fatigue: It’s normal to feel exhausted after a session.
- Blood clots: Could form at the point of entry.
- Nausea and vomiting: Rapid alterations in the chemical balance of the blood can cause these.
2. Peritoneal Dialysis
When the kidneys can no longer efficiently eliminate waste products and excess fluid from the body, another type of dialysis treatment called peritoneal dialysis (PD) is employed. Peritoneal dialysis employs the peritoneum, a naturally occurring membrane covering the abdominal cavity, as a filter, in contrast to hemodialysis, which filters the blood outside the body using a machine.
How Peritoneal Dialysis Works
1. Peritoneum Access
- Catheter: A soft, flexible tube that is surgically inserted into the abdominal cavity. The dialysis solution enters and exits the peritoneum through this catheter.
2. Dialysate, or Dialysis Solution
- Sterile Solution: Through the catheter, a sterile solution containing electrolytes and the sugar dextrose is inserted into the abdominal cavity.
- Waste Removal: Waste materials and extra fluid are drawn into the solution by the dialysate from the tiny blood veins in the peritoneum.
3. Procedure for Filtration
- Dwell Period: Waste materials and extra fluid from the bloodstream enter the dialysate through the peritoneal membrane throughout the dialysate’s specified dwell period, which lasts in the abdomen.
- Drain Phase: Following the dwell period, the catheter is utilised to drain the used dialysate, which contains waste products, out of the abdomen.
4. Cycles of Exchange
- Multiple Exchanges: To obtain sufficient waste product clearance, this filling, dwelling, and draining procedure of the dialysate usually needs to be performed several times during the day and night.
Types of Peritoneal Dialysis
Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Manual Exchanges: Patients are given several opportunities to do manual swaps throughout the day, which gives them the independence to go about their everyday lives.
- Duration: Usually, each trade takes between thirty and forty minutes.
Automated Peritoneal Dialysis (APD)
- Cycler Machine: Uses a device called a cycler to carry out several exchanges automatically while the patient is asleep.
- Scheduled Exchanges: Every exchange is scheduled and takes a few hours, giving patients uninterrupted dialysis all night long.
Benefits of Peritoneal Dialysis
- Flexibility: Gives patients, particularly those with CAPD, greater autonomy in scheduling their treatments.
- Less Dietary Restrictions: Peritoneal dialysis has fewer dietary restrictions than hemodialysis because it is a continuous process that helps maintain more stable fluid and electrolyte levels.
- Preserving Remaining Kidney Function: Compared to hemodialysis, peritoneal dialysis may be able to preserve some residual kidney function.
Potential Risks and Complications
- Peritonitis: An infection of the peritoneum, a dangerous side effect that needs to be treated with antibiotics right away.
- Hernias: A higher risk since the abdomen is constantly filled with dialysis fluid.
- Fluid Overload: When there are problems with fluid balance or insufficient dialysis.
- Exit Site Infections: Infections at the catheter’s departure point are known as exit site infections.
- Protein Loss: As a result of the peritoneum’s ongoing exposure to the dialysis fluid.
Conclusion
A crucial treatment for people with severe renal failure or dysfunction is hemodialysis. Maintaining health and controlling the signs and consequences of renal failure necessitates routine sessions. The process accurately replicates the filtration role of healthy kidneys, enabling patients to lead more stable and busy lifestyles.
For those with renal failure, peritoneal dialysis is a crucial therapeutic choice since it provides flexibility and the opportunity to do dialysis at home (with the right training). It uses the body’s peritoneal membrane to filter waste materials and extra fluid, offering either continuous or sporadic therapy to preserve health and treat kidney failure symptoms. The decision between hemodialysis and peritoneal dialysis is frequently influenced by a patient’s lifestyle, preferences, and medical needs.
