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Dialysis

Dialysis

Dialysis is a medical treatment used when the kidneys are unable to filter waste, excess fluids, and toxins from the blood effectively. This condition is known as kidney failure or end-stage renal disease (ESRD). Dialysis performs the essential functions of the kidneys to maintain the body's balance of fluids, electrolytes, and waste.

Why is Dialysis Needed?

Dialysis is required when the kidneys lose about 85-90% of their function and cannot keep up with the body’s needs. Some common causes of kidney failure that may lead to dialysis include:

  • Chronic Kidney Disease (CKD): Progressive loss of kidney function over time due to conditions like diabetes and hypertension.

  • Acute Kidney Injury (AKI): Sudden kidney failure due to trauma, severe infections, or drug toxicity.

  • Polycystic Kidney Disease: A genetic disorder causing cysts in the kidneys.

  • Glomerulonephritis: Inflammation of the kidney’s filtering units.

  • Urinary Tract Obstruction: Blockages like kidney stones or tumors preventing normal kidney function.

Without dialysis, harmful waste products like urea, creatinine, and excess fluids build up in the body, leading to serious complications such as:

  • Fluid Overload: Causing swelling, high blood pressure, and heart failure.

  • Electrolyte Imbalance: Leading to life-threatening conditions like high potassium (hyperkalemia), which can cause heart arrhythmias.

  • Metabolic Acidosis: Increased acid levels in the blood, leading to organ dysfunction.

  • Uremia: A toxic buildup of waste in the blood, causing confusion, nausea, vomiting, and itching.

Types of Dialysis

1. Hemodialysis (HD)

Hemodialysis is a process where a machine (artificial kidney) filters waste, excess fluids, and toxins from the blood.

How it Works:

  • A vascular access (fistula, graft, or catheter) is created to draw blood from the body.

  • Blood is passed through a dialysis machine, where a special filter called a dialyzer removes waste and excess fluids.

  • The cleaned blood is returned to the body.

Procedure:

  • Performed 3-4 times per week, with each session lasting 3-5 hours.

  • Conducted at a dialysis center, hospital, or sometimes at home.

Advantages:

  • Effectively removes toxins and excess fluids.

  • Performed under medical supervision.

Disadvantages:

  • Requires frequent visits to a dialysis center.

  • Can cause complications like low blood pressure, muscle cramps, and infections.

2. Peritoneal Dialysis (PD)

Peritoneal dialysis uses the peritoneal membrane (lining of the abdominal cavity) to filter waste from the blood.

How it Works:

  • A catheter is surgically placed in the abdomen.

  • A dialysis solution (special fluid) is introduced into the abdominal cavity.

  • The peritoneal membrane acts as a natural filter, allowing waste and excess fluids to pass into the solution.

  • After a few hours, the fluid containing waste is drained and replaced with fresh solution.

Types of Peritoneal Dialysis:

  1. Continuous Ambulatory Peritoneal Dialysis (CAPD):

    • Manual exchange of dialysis fluid 3-4 times a day.

    • No machine is required.

    • Can be done at home or work.

  2. Automated Peritoneal Dialysis (APD):

    • A machine (cycler) automatically performs fluid exchanges at night while the patient sleeps.

    • More convenient for those with busy lifestyles.

Advantages:

  • Can be done at home, allowing more flexibility.

  • No need for frequent hospital visits.

  • Less dietary restrictions compared to hemodialysis.

Disadvantages:

  • Higher risk of infections like peritonitis.

  • Requires a permanent catheter in the abdomen.

  • May not be suitable for all patients, especially those with abdominal surgery history.

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