29 Jul 20 5:53:11 PM
There are different types of dialysis. The three main approaches are:
The choice will depend on factors such as the patient’s situation, availability, and cost.
The kidneys are crucial for eliminating waste, and other functions. In hemodialysis, the blood circulates outside the body. It goes through a machine with special filters. The blood comes out of the patient through a flexible tube known as a catheter. The tube is inserted into the vein. Like the kidneys, the filters remove the waste products from the blood. The filtered blood then returns to the patient through another catheter. The system works like an artificial kidney. Those who are going to have hemodialysis need surgery to enlarge a blood vessel, usually in the arm. Enlarging the vein makes it possible to insert the catheters.
Hemodialysis is usually done three times a week, for 3 to 4 hours a day, depending on how well the kidneys work, and how much fluid weight they have gained between treatments. Hemodialysis can be done in a special dialysis center in a hospital or at home. People who have dialysis at home, or their caregiver, must know exactly what to do. If a person does not feel confident doing dialysis at home, they should attend sessions at the hospital.
Home hemodialysis is suitable for people who:
The home environment must also be suitable for taking hemodialysis equipment.
While hemodialysis removes impurities by filtering the blood, peritoneal dialysis works through diffusion. In peritoneal dialysis, a sterile dialysate solution, rich in minerals and glucose, is run through a tube into the peritoneal cavity, the abdominal body cavity that surrounds the intestine. It has a semi-permeable membrane, the peritoneal membrane. Peritoneal dialysis uses the natural filtering ability of the peritoneum, the internal lining of the abdomen, to filter waste products from the blood.
The dialysate is left in the peritoneal cavity for some time, so that it can absorb waste products. Then it is drained out through a tube and discarded. This exchange, or cycle, is normally repeated several times during the day, and it can be done overnight with an automated system. The elimination of unwanted water, or ultrafiltration, occurs through osmosis. The dialysis solution has a high concentration of glucose, and this causes osmotic pressure. The pressure causes the fluid to move from the blood into the dialysate. As a result, more fluid is drained than is introduced.
Before starting peritoneal dialysis, the patient needs a small surgical procedure to insert a catheter into the abdomen. This is kept closed off, except when being used for dialysis. There are two main types of peritoneal dialysis:
Continuous ambulatory peritoneal dialysis (CAPD) requires no machinery, and the patient or a caregiver can do it.
The dialysate is left in the abdomen for up to 8 hours and then replaced with a fresh solution straight away. This happens every day, four or five times per day.
Continuous cyclic peritoneal dialysis (CCPD), or automated peritoneal dialysis uses a machine to exchange the fluids. It is generally done every night, while the patient sleeps. Each session lasts from 10 to 12 hours. After spending the night attached to the machine, most people keep the fluid inside their abdomen during the day. Some patients may need another exchange during the day. Peritoneal dialysis is a suitable option for patients who find hemodialysis too exhausting, such as elderly people, infants, and children. It can be done while traveling, so it is more convenient for those who work or attend school.
Dialysis can be intermittent or continuous. While a session of intermittent dialysis lasts for up to 6 hours, continuous renal replacement therapies (CRRT) are designed for 24-hour use in an intensive care unit (ICU).
There are different types of CRRT. It can involve either filtration or diffusion. It is better tolerated than intermittent dialysis, because the solute or fluid removal is slower. This leads to fewer complications, for example, a lower chance of hypotension.
Sometimes dialysis is given for a limited period of time.
People who may benefit from temporary dialysis include those who:
Risks and complications include:
In some cases, the kidneys recover and do not need further treatment.
" Medically reviewed by Alana Biggers, M.D., MPH on July 17, 2018 — Written by Yvette Brazier"
5/7/2024
*T & C Apply
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