Dialysis

Dialysis:
Dialysis is a process of removing toxic metabolic wastes from body.
Dialysis is of two types

• Hemodialysis
• Peritoneal Dialysis

Hemodialysis:
Hemodialysis is a process in which the patient’s blood is obtained through a vascular access (e.g. Fistula, Catheter, and Shunt) and passed through a special filter called Hemodialyser where the blood is cleared of excess wastes (Like urea, Creatinine, Potassium, acids etc) and water, the purified blood is returned back to the patient

Advantages:

• Lesser chances of Infection
• Less expensive as compared to Peritoneal dialysis (PD)

Disadvantages:

• Needs to visit hospital or a dialysis centre regularly
• Not suitable for patients with severe Heart problems (Cardiac Problems).
• More requirement of blood donation is there.

Continuous Ambulatory Peritoneal Dialysis (CAPD):  Inside our abdomen there is a natural lining called peritoneum. This Peritoneum is a semi permeable membrane that surrounds the intestines and other organs. In Peritoneal dialysis a specially formulated dialysate solution is infused in to the patient’s abdomen using a catheter that is surgically implanted. The catheter is small and can be contained in a belt. It does not cause any pain or discomfort to the patient; neither anybody can come to know that there is something artificial in patients body. In other words a properly inserted and maintained catheter is painless and has no negative cosmetic issues.

 After a stipulated prescribed time the dialysate solution is brought out and again a fresh dialysate is infused. This process is repeated three times a day.


Advantages:

• Easy to learn and can be done at home.
• Fluid and Diet restrictions are minimal.
• Blood transfusion requirement is much less than Hemodialysis.

Disadvantages:

• Requires good hygiene and daily one attendant has to spend some time in doing the CAPD exchanges.
• Higher chances of Infection (Peritonitis).

Vascular access for Hemodialysis Patients:
 A Vascular Access is the way of obtaining blood for dialysis. There are two types of vascular access

• Temporary Access
• Permanent  Access

Temporary Vascular Access: Temporary access is usually obtained by inserting a plastic tube like structure in to the patient’s central vein such as in Jugular, Subcalvian, and Femoral Veins. Alternatively A.V Shunt can be surgically created, connecting a soft silicone tube in to the patients artery and vein.. Temporary access is the choice when patient doesn’t have permanent access or in cases where there is an urgent need for dialysis

 

Advantages:

• Can be used immediately
• Needle pricks not required

Disadvantages:

• Usually doesn’t last longer and gets clotted.
• More chances of Infection as compared to AV Fistula.

Taking care of Catheters:

• Keep dressing clean and dry.
• Make sure the dialysis team changes the dressing at each           dialysis session.
• Never open the catheter dressing on your own.
• Do not wet the access when taking bath, swimming, or taking showers.
• Check for signs of infection e.g. fever, redness around access site, feeling extremely cold (Chills).