Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your body in balance when the kidneys can’t do their job Properly functioning kidneys prevent extra water, waste, and other impurities from accumulating in your body. They also help control blood pressure and regulate the levels of chemicals in the blood, such as sodium, or salt, and potassium. They even activate a form of vitamin D that improves the absorption of calcium.
When your kidneys can’t perform these functions due to disease or injury, dialysis can help keep the body running as normally as possible.
Dialysis is an artificial way of cleaning your blood. There are two different types of dialysis:
- Peritoneal Dialysis
Hemodialysis is the most common type of dialysis. It uses an artificial kidney, known as a hemodialyzer, to remove waste and chemicals from your blood. To get the blood to flow to the artificial kidney, your doctor will surgically create a vascular access, or an entrance point, into your blood vessels. This vascular access will allow a larger amount of blood to flow through your body during hemodialysis treatment. This means more blood can be filtered and purified.
The two type of vascular access designed for long-term dialysis treatments are an arteriovenous (AV) fistula, which connects an artery and a vein and an AV graft, which is a looped tube. For short-term use, a catheter may be inserted into the large vein in your neck.
Hemodialysis treatments usually last three to five hours. The treatment is typically needed three times per week. However, hemodialysis treatment can also be done in shorter, more frequent sessions.
Most hemodialysis treatments are done at a hospital, doctor’s office, or dialysis center. The length of treatment depends on your body size and the amount of waste in your body.
After you’ve been on hemodialysis for an extended amount of time, your doctor may feel that you’re ready to give yourself dialysis treatments at home. This option is more common for people who will need long-term treatment.
Peritoneal dialysis involves surgery to implant a catheter into your belly area. During treatment, a special fluid called dialysate flows into your abdomen. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.
There are numerous different types of peritoneal dialysis, but the main ones are continuous ambulatory peritoneal dialysis and continuous cycler-assisted peritoneal dialysis. In continuous ambulatory peritoneal dialysis, your abdomen is filled and drained multiple times each day. Continuous cycler-assisted peritoneal dialysis, however, uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep.
Peritoneal dialysis can be done at home. You’ll receive training on how to perform the steps of the treatment.
Renal replacement therapy
Renal replacement therapy (RRT) is therapy that replaces the normal blood-filtering function of the kidneys. It is used when the kidneys are not working well, which is called renal failure and includes acute kidney injury and chronic kidney disease. Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machine. Renal replacement therapy also includes kidney transplantation, which is the ultimate form of replacement in that the old kidney is replaced by a donor kidney.
These treatments are not truly cures for kidney disease. In the context of chronic kidney disease, they are more accurately viewed as life-extending treatments, although if chronic kidney disease is managed well with dialysis and a compatible graft is found early and is successfully transplanted, the clinical course can be quite favorable, with life expectancy of many years. Likewise, in certain acute illnesses or trauma resulting in acute kidney injury, a person could very well survive for many years, with relatively good kidney function, before needing intervention again, as long as they had good response to dialysis, they got a kidney transplant fairly quickly if needed, their body did not reject the transplanted kidney, and they had no other significant health problems. Early dialysis (and, if indicated, early renal transplant) in acute renal failure usually brings more favorable outcomes.
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