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What Is Dialysis?
- Dialysis is a common procedure performed in hospitals.
- Generally, dialysis means the dissolution of solutes in the solvent.
- It is a technique that involves the removal of waste products and excess water from the blood.
- It is used as an artificial replacement for lost kidney function in a patient with renal failure.
- Dialysis is also referred to as the holding measure until the kidney from the donor is present for transplantation.
- It used during end-stage renal disease (ESRD).
- Plasma Urea > 180 mg/dL (normal range: 6-24 mg/dL) and creatinine > 6.8 mg/dL (normal range: 0.6-1.3 mg/dL)
- Uraemic Encephalopathy
- Hyperkalaemia > 6 mmol/L (normal range of potassium:4.5-5.5 mmol/L)
- Metabolic Acidosis
- Uraemic Pericarditis
- Fluid overload and pulmonary edema.
- Hemodialysis
- Peritoneal Dialysis
- Hemodialysis is a dialysis method in which there is a diffusion of solutes between dialysate fluid and plasma across a semi-permeable membrane following the concentration gradient.
- A semi-permeable membrane is made of cellulose acetate, cellulose, or synthetic material.
- This technique is more efficient than peritoneal dialysis in the removal of creatinine and urea.
- Conventional
- Non-conventional
- Patient
- Heparin to prevent blood clotting while passing through the machine
- Saline
- Dialysate fluid
- Pressure monitor
- Blood pump
- Dialyser (Reserviour with semi-permeable membrane)
- Catheters
- Tubings, etc.
- Firstly, connect all the tubing, containers to the dialysis machine and then to the patient.
- Heparin is given to prevent the clotting of blood as it passes through the machine.
- Vascular access should be obtained by placing a catheter into the femoral or internal jugular vein.
- Blood from the patient is slowly made to flow through the dialysis machine that consists of a semi-reservoir and permeable membrane, pressure monitors, etc. The membrane separates the dialysis fluid and blood to be filtered.
- The solutes like creatinine, potassium, and urea move from the higher concentration region i.e, from blood to the lower concentration region i.e, to the dialysis fluid through a semi-permeable membrane.
- The used fluid is removed by applying the negative pressure to the dialysate side (ultrafiltration).
- After passing through the dialysis machine blood returns to the patient.
- Although, initially hemodialysis is done for 1 hour to avoid the sudden change in the electrolyte and fluid balance in the patient.
- Subsequently, hemodialysis is performed for 3-4 hours and 3-4 times a week.
- In the peritoneal dialysis procedure, the peritoneal itself acts as a semi-permeable membrane for the filtration of the blood.
- It is not a common technique used in acute renal failure.
- Patient
- Catheter
- Tubings
- Dialysate fluid, etc.
Procedure To Perform Peritoneal Dialysis:
- A catheter is introduced into a peritoneum in the abdominal cavity.
- A tube is used to connect the catheter and the dialysate fluid.
- Around 1.5-3 liters of a dextrose-containing solution is infused into the peritoneal cavity and allowed to dwell for 2-4 hours.
- During this period, the waste products and the uremic toxins diffuse from the blood to the dialysis fluid through the peritoneum.
- In this technique, the peritoneum itself acts as a semi-permeable membrane.
- The used dialysate fluid containing waste products is removed and fresh dialysis fluid is infused.
Two Types Of Peritoneal Dialysis:
1. Continuous Ambulatory Peritoneal Dialysis (CAPD):
This technique involves multiple times (3-4 times) exchanges of fluids during a day with an overnight dwell of dialysis fluid in the peritoneum. The dialysis fluid is usually infused into the abdomen at bedtime and is drained upon awakening.
2. Continuous Cyclic Peritoneal Dialysis (CCPD):
This is an automated form of dialysis procedure in which a machine is used to perform exchanges while the patient is sleeping or unconscious. There might be a long daytime dwell i.e, fluid is infused in the abdomen during daytime and occasionally a manual daytime exchange is done.



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