Dialysis is a medical procedure used to perform some of the functions of the kidneys when they are unable to do so adequately. It is primarily used to treat individuals with end-stage renal disease (ESRD) or severe kidney failure. Dialysis helps remove waste products, excess fluids, and electrolytes from the blood, maintaining the body's balance of essential substances. There are two main types of dialysis:
Hemodialysis (HD):
- Procedure: Hemodialysis involves the use of a machine called a hemodialyzer or dialysis machine. A patient's blood is pumped through a dialysis machine, which contains a special filter called a dialyzer. The dialyzer cleans the blood by removing waste products and excess fluids.
- Access: To facilitate the flow of blood to and from the dialysis machine, patients often require vascular access, which can be established through an arteriovenous (AV) fistula, AV graft, or central venous catheter.
- Frequency: Hemodialysis is typically performed in a dialysis center, hospital, or at home, depending on the patient's needs. It is usually done three times a week, with each session lasting several hours.
Peritoneal Dialysis (PD):
- Procedure: Peritoneal dialysis uses the patient's own peritoneal membrane (a thin lining in the abdomen) as a natural filter. A sterile solution called dialysate is introduced into the abdominal cavity through a catheter. Waste products and excess fluids diffuse from the blood vessels into the dialysate solution. After a set dwell time, the used solution is drained, and fresh solution is added.
- Access: Patients who undergo peritoneal dialysis have a peritoneal catheter surgically placed in the abdomen.
- Frequency: Peritoneal dialysis can be performed at home by the patient or a caregiver, and it is often done daily. There are various schedules and techniques, including continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD).
Key points about dialysis:
- Lifesaving Treatment: Dialysis is a life-saving treatment for individuals with kidney failure. It helps maintain the balance of electrolytes and removes waste products from the body when the kidneys are unable to do so.
- Diet and Fluid Restrictions: Patients on dialysis often need to follow specific dietary restrictions, including limiting salt, potassium, and phosphorus intake. They may also have restrictions on fluid intake to prevent fluid overload.
- Medication Management: Dialysis patients may require medications to manage conditions associated with kidney failure, such as anemia and hypertension.
- Regular Monitoring: Dialysis patients require regular monitoring by healthcare providers to assess their overall health, adjust dialysis prescriptions, and address any complications that may arise.
- Transplant Evaluation: Many individuals on dialysis are candidates for kidney transplantation. They may undergo evaluation for a kidney transplant, which can offer a more long-term solution to kidney failure.
- Dialysis is a critical therapy for individuals with advanced kidney disease, but it is not a cure for kidney failure. Patients on dialysis often work closely with a healthcare team that includes nephrologists, nurses, dietitians, and social workers to manage their condition and improve their quality of life.