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How Does Dialysis Treat Kidney Failure

How Does Dialysis Treat Kidney Failure?

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:

  1. Elimination of waste, salt, and excess water from the body and prevent accumulation of the same in the body
  2. Maintains a safe level of specific chemicals in your blood, such as potassium, sodium, and bicarbonate
  3. Regulates blood pressure

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.

Types Of Dialysis

There are two types of dialysis, namely:

  1. Hemodialysis
  2. Peritoneal dialysis

1. Hemodialysis

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.

Procedure

Before beginning hemodialysis, you will have a small surgical operation to allow better access to the bloodstream. You may have:

  1. Arteriovenous fistula (AV fistula): An artery and vein in your arm are connected by a surgeon.
  2. Arteriovenous graft (AV graft): If the artery and vein are too short to unite, your surgeon will use a graft (a soft, hollow tube) to join them.

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:

  1. Removes blood from a needle in your arm.
  2. Circulates blood through a dialyzer filter, transferring waste into a dialysis solution. This washing liquid is made up of water, salt, and other ingredients.
  3. Returns filtered blood to your body through a separate needle in your arm.
  4. Check your blood pressure to see how quickly blood moves in and out of your body.

Side Effects

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:

  1. Chest pain or back pain
  2. Headaches
  3. Itchy skin
  4. Muscle cramps
  5. Restless legs syndrome

The duration of dialysis depends on various factors like:

  1. Your kidney functions
  2. Fluid weight gained in between dialysis
  3. Quantity of your body waste
  4. Your body weight
  5. The kind of prosthetic kidney is utilised in dialysis

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.

Potential Risk

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.

2. Peritoneal Dialysis

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:

  1. Continuous ambulatory peritoneal dialysis (CAPD) is performed manually. The only type of peritoneal dialysis that is performed without the use of machinery is Continuous Ambulatory Peritoneal Dialysis (CAPD). You do it yourself four or five times a day at home or work. Through the catheter, you insert a bag of dialysate (approximately two quarts) into your peritoneal cavity. The dialysate remains there for around four to five hours before being drained back into the bag and discarded. This is known as an exchange. Each exchange requires the use of a new bag of dialysate. You can go about your normal activities at work, school, or home while the dialysate is in your peritoneal cavity.
  2. Automated peritoneal dialysis uses a machine

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.

Procedure

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:

  1. Connect the catheter to one of the Y-shaped tube’s branches. This tube connects to a dialysis solution bag.
  2. The solution enters the peritoneal cavity via the tube and catheter.
  3. When the bag is empty, disconnect the tube and catheter after about 10 minutes. Remove the catheter’s cap.
  4. Carry on as usual while the dialysis solution within the peritoneal cavity collects waste and excess fluids from the body. This procedure takes between 60 and 90 minutes.
  5. Remove the catheter’s cover and drain the fluid into a clean, empty bag using the other branch of the Y-shaped tube.

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.

Side Effects

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.

Potential Risk

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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