Types of Dialysis
The kidneys play an extremely important role in the healthy functioning of the body, as they are responsible for maintaining the balance of salts, water, and acid-base, as well as removing toxic substances. However, these vital organ systems can become ill due to various conditions, which can have serious consequences. When kidney function dramatically declines, medical intervention becomes inevitable to save the patient’s life.
Kidney failure, whether acute or chronic, is a condition that makes normal bodily functions difficult. In such cases, dialysis, as a kidney replacement therapy, becomes essential for patients. Dialysis does not improve kidney function but rather replaces its functions. The goal of treatment is to remove toxins and excess fluid from the blood, allowing the patient to maintain their health and quality of life. The processes and types of dialysis are diverse and require medical supervision in every case.
The necessity and types of dialysis
The procedure of dialysis becomes necessary when the kidneys can no longer effectively remove waste products and excess fluids. This is typically indicated by a decrease in the glomerular filtration rate (GFR), which is a measure of kidney function. If the GFR falls below 15 ml/min/1.73 m², the patient may experience serious symptoms, and dialysis becomes inevitable. Dialysis does not cure kidney disease but compensates for kidney function, so patients must regularly participate in treatment, usually 2-3 times a week.
Dialysis is primarily available in three forms: hemodialysis, peritoneal dialysis, and hemofiltration. Each method has different advantages and disadvantages, and the choice often depends on the patient’s condition, lifestyle, and medical recommendations. In hemodialysis, blood is filtered through a dialysis machine, while peritoneal dialysis uses the peritoneum as a filter membrane. Hemofiltration, on the other hand, specializes in rapid detoxification.
The process of hemodialysis
In hemodialysis, a patient’s blood is cleaned by first creating an arteriovenous fistula, which allows blood to circulate through the dialysis machine. The Cimino fistula, which connects an artery and vein in the forearm, is most commonly used. This procedure facilitates the dilation of the vein, making it suitable for handling large volumes of blood. The dialysis system typically requires two needles: one is the arterial needle that sends blood to the machine, and the other is the venous needle that returns the cleaned blood to circulation.
During hemodialysis, blood passes through a dialysis membrane, where filtration occurs with the dialysis fluid. During this process, excess substances and toxins enter the dialysis fluid, while the cleaned blood is returned to the patient. The treatment usually lasts 3-4 hours and is required 2-3 times a week. It is important to note that hemodialysis not only removes toxins but also excess fluid, thereby helping to stabilize the patient’s condition.
The advantages of peritoneal dialysis
Peritoneal dialysis is an alternative method that uses the peritoneum as a filter membrane. This solution allows patients to perform the treatment at home, thus reducing hospital stays. During the treatment, a Tenckhoff catheter is placed in the abdominal cavity, through which the dialysis fluid is introduced. The fluid remains in the abdominal cavity for a while, allowing harmful substances to pass through the peritoneum.
After an hour, the fluid is drained, and the process is restarted. This method is particularly beneficial for bedridden patients, as it allows for comfortable home treatment. Continuous ambulatory peritoneal dialysis (CAPD) does not require hospitalization; the patient can perform the treatment three times a day without interrupting their daily routine. However, it is crucial to maintain sterility, as inadequate hygiene can lead to infections.
The application and effects of hemofiltration
Hemofiltration is a specific form of dialysis applied for rapid detoxification when dissolved toxins need to be removed from the blood. In this method, the membrane used has larger pore sizes than in hemodialysis, allowing for faster and more effective filtration. Hemofiltration is mainly used in emergency situations when immediate blood purification is required.
The process of hemofiltration is painless, but after treatment, patients may experience drops in blood pressure, fatigue, or bleeding disorders. Symptoms may worsen if dialysis is missed, so it is extremely important for patients to regularly attend treatments. Dialysis can also be performed in febrile conditions, allowing patients to continue treatment while receiving necessary healthcare.
Thus, dialysis is an essential procedure that helps to replace kidney functions, yet it does not substitute for the hormonal functions of the kidney. Diet and medication adherence are crucial for patients to maintain their health and well-being alongside treatments.
