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Revision as of 14:17, 10 February 2025
Dialysis is a medical procedure that artificially removes waste products and excess fluids from the blood when the kidneys are no longer able to perform these functions adequately. Dialysis is commonly prescribed for patients with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD).
There are two primary forms of dialysis: hemodialysis and peritoneal dialysis. Dialysis is a life-sustaining treatment for individuals with kidney failure, but it is not a cure, and patients often require dialysis for the rest of their lives unless they undergo a kidney transplant.
Hemodialysis
Hemodialysis is a procedure that uses a machine, sometimes called an artificial kidney, to filter waste products and excess fluids from the blood. During hemodialysis, the patient's blood is circulated through a dialyzer, a device containing a semipermeable membrane that removes waste products and excess water. Hemodialysis typically requires treatments at a specialized dialysis center several times a week, with each session lasting approximately 3 to 5 hours.
Vascular Access
For hemodialysis, a patient requires a stable and functional vascular access, which can be achieved through the following methods:
- Arteriovenous (AV) fistula: A surgical connection between an artery and a vein, typically in the arm, which provides a durable and reliable access point for hemodialysis.
- AV graft: A synthetic tube that connects an artery and a vein, used when the patient's blood vessels are not suitable for an AV fistula.
- Venous catheter: A temporary access method, in which a catheter is inserted into a large vein, often in the neck or chest.
Peritoneal Dialysis
- Peritoneal dialysis uses the patient's own peritoneum, a thin membrane lining the abdominal cavity, as a natural filter to remove waste products and excess fluids from the blood. A catheter is surgically placed into the abdomen, allowing the introduction of a sterile dialysis solution that absorbs waste products and excess water before being drained from the body.
Peritoneal dialysis can be further categorized into two main types:
- Continuous Ambulatory Peritoneal Dialysis (CAPD): The patient manually performs multiple exchanges of dialysis solution throughout the day, typically at home or work.
- Automated Peritoneal Dialysis (APD): A machine, called a cycler, automatically performs exchanges of dialysis solution during the night while the patient sleeps.
The choice of dialysis method depends on factors such as the patient's age, health, and lifestyle.
Complications
Both hemodialysis and peritoneal dialysis can lead to complications, including:
- Infections
- Low blood pressure
- Anemia
- Muscle cramps
- Peritonitis (inflammation of the peritoneum, more common in peritoneal dialysis)
See Also
References
<references> Levin A, Stevens PE,
Summary of KDIGO 2012 CKD Guideline: behind the scenes, need for guidance, and a framework for moving forward, Kidney International, 2014, Vol. 85(Issue: 1), pp. 49–61, DOI: 10.1038/ki.2013.444, PMID: 24067435,
Vanholder R, Annemans L, Brown E, et al.,
Reducing the costs of chronic kidney disease while delivering quality health care: a call to action, Nature Reviews Nephrology, 2017, Vol. 13(Issue: 7), pp. 393–409, DOI: 10.1038/nrneph.2017.63, PMID: 28561005,
Blake PG, Bargman JM,
Review of Peritoneal Dialysis: From Bench to Bedside, Contributions to Nephrology, 2017, Vol. 191, pp. 1–8, DOI: 10.1159/000479177, PMID: 28607968,
Agarwal SK, Srivastava RK,
Chronic kidney disease in India: challenges and solutions, Nephron Clinical Practice, 2009, Vol. 111(Issue: 4), pp. c197–c203, DOI: 10.1159/000183979, PMID: 19169020,
</references>
