Kidneys are part of the human urinary system. On either side of the spine, these two bean-shaped organs lay below the rib cage. They remove toxins from the blood and replace them with filtered and nutrient-rich blood to the bloodstream. The extra water and waste make urine, moving from the kidneys into the bladder. The kidneys also help regulate blood pressure. Kidneys filter your blood by eliminating waste and excess water, producing urine.
Dialysis is a type of treatment that replicates the functions of healthy kidneys. It is required when your kidneys are no longer capable of fulfilling your body’s requirements.
One needs dialysis when they acquire end-stage renal failure, which typically occurs once they’ve lost 85 to 90% of their kidney function and have a GFR (glomerular filtration rate) of less than 15. The GFR is a measurement of how successfully your kidneys filter blood. Dialysis maintains your body balance when your kidneys fail by:
Kidney failure is usually irreversible. Some types of acute kidney failure, also known as acute renal failure, do improve with treatment. Dialysis may only be required for a short time in some cases of acute renal failure until the kidneys recuperate. The kidneys do not recover in chronic or end-stage renal failure, and the patient will require dialysis for the rest of his life.
Dialysis is often performed in a hospital, a dialysis unit outside of a hospital, or at home. Depending on the patient’s medical state, the patient and doctors decide on the best dialysis venue, mutually.
There are two types of dialysis, namely:
A machine takes blood from your body, filters it via a dialyzer (artificial kidney), and returns the cleansed blood to your body using hemodialysis. This 3- to 5-hour procedure may be performed three times each week in a hospital or dialysis clinic. Hemodialysis can also be performed at home. You may require at-home treatments four to seven times a week for fewer than two hours each time. You can undergo hemodialysis at night while sleeping.
Before beginning hemodialysis, you will have a small surgical operation to allow better access to the bloodstream. You may have:
AV fistulas and grafts increase the connected artery and vein, making dialysis access more convenient. They also aid in the quicker flow of blood in and out of the body. If dialysis is required instantly, your physician may insert a catheter (a thin tube) into a vein in your neck, chest, or leg to enable temporary access. Your physician will educate you on how to keep the fistula or graft infection-free.
The dialysis machine performs the following functions during hemodialysis:
Low blood pressure can occur during or soon after hemodialysis for certain individuals. You may feel dizzy, nauseous, or faint. Other hemodialysis side effects include:
The duration of dialysis depends on various factors like:
Each hemodialysis treatment typically lasts four hours and is performed three times a week.
High-flux dialysis, a kind of hemodialysis, requires less time. You can consult with your doctor to determine whether it is an appropriate therapy for you.
Some individuals experience complications with the AV fistula or graft. An infection, inadequate blood flow, or a blockage caused by scar tissue or a blood clot are all possibilities.
During dialysis, the dialysis needle seldom comes out of the arm, nor does a tube come out of the machine. A blood leak detecting device warns patients and medical personnel of the situation. The machine is temporarily turned off while the problem is resolved. This mechanism guard against blood loss.
Peritoneal dialysis involves the use of microscopical vessels inside the abdominal lining (peritoneum) to filter blood with the use of a dialysis solution. This solution is a cleansing liquid made up of water, salt, and other additives. Peritoneal dialysis is performed at home.
There are two approaches to this treatment:
APD (Automated Peritoneal Dialysis) is often performed at home using specific equipment known as a cycler. This is similar to CAPD, except that it involves several cycles (exchanges). Each cycle lasts around an hour and a half, and exchanges take place throughout the night while patients sleep.
A small surgical procedure will be performed around three weeks before you begin peritoneal dialysis. A soft, thin tube (catheter) is inserted through your abdomen and into the peritoneum by a surgeon. This catheter is permanently implanted. A healthcare expert will educate you on how to administer peritoneal dialysis at home and how to prevent catheter-site infections.
The steps in peritoneal dialysis are:
These steps should be repeated up to four times each day. Some patients prefer to have their peritoneal dialysis at night. A machine called a cycler pumps fluid into and out of your body as you sleep with automated peritoneal dialysis.
The fluids in the stomach may cause the patient to feel bloated or full. Although it may seem unpleasant, the procedure is not painful. When the stomach is full of fluid, it may protrude more than usual.
Some patients get skin infections near the catheter. You’re also at risk for peritonitis, an infection caused by germs entering the abdomen through the catheter. Fever, stomach discomfort, nausea, and vomiting are all possible symptoms.
Using an abdominal catheter and pumping liquids into the abdomen might weaken abdominal muscles over time. One might get a hernia. When an organ, such as the small intestine, pokes through the abdominal muscles, this condition develops. A protrusion at the belly button or in the pelvic area between the abdomen and upper thigh may be felt. A hernia can be repaired surgically by a doctor.
The body absorbs dextrose, a sugar, from the dialysis fluid during peritoneal dialysis. This excess sugar might contribute to weight gain over time.
If your kidneys fail, you will need dialysis treatments for the rest of your life unless you can receive a kidney transplant. Life expectancy on dialysis varies according to the underlying medical problems and how well a patient adheres to the treatment plan. The average dialysis life expectancy is 5-10 years; nevertheless, several people have lived well on dialysis for 20 or even 30 years.
Except for the time required for treatments, many dialysis patients lead regular lives. Dialysis typically makes you feel better since it helps reduce several of the symptoms of renal failure. It takes some time for the patient and their family to adjust to dialysis.
Many dialysis patients maintain busy lifestyles, working, raising families, and travelling. When you travel, your healthcare professional can assist you in arranging dialysis at a facility in your new location. If you’re practising either sort of self-dialysis, you can bring dialysis solution bags and (if necessary) a portable home dialysis machine with you.
As the abdomen fills with dialysis solution, those who use peritoneal dialysis may need to limit activities. Otherwise, exercise is usually safe for dialysis patients.
Get in touch with the doctor if you experience any of the followings:
Since the mid-1940s, hemodialysis and peritoneal dialysis have been performed. Dialysis was first used as a regular treatment in 1960 and has since become a routine treatment all around the world. CAPD was founded in 1976. These treatments have aided thousands of patients.
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