What is chronic dialysis?
When the kidneys fail due to injury or disease, it leads to dangerous accumulation of substances in the blood. Dialysis is a procedure that performs some of the functions of normal healthy kidneys, including the removal of fluid, electrolytes and by -products of cell metabolism. Dialysis can also help control blood pressure and maintain blood acid balance. If dialysis is required for a longer period of time, it is called chronic dialysis.
Chronic kidney failure leading to the final kidney disease (ESRD) is a primary indication for chronic dialysis. In the United States, ESRD is most often the result of long -term diabetes or high blood pressure. Without dialysis, ESRD is fatal. Several hundred thousand patients in the US and several million worldwide receive chronic dialysis every year.
When to initiate dialysis for ESRD, it differs significantly from the patient to the patient. Generally, patients have lost 85 to 90 percent of the normal kidney function and have the Symaty of Esrd. In many, dialysis is necessary when another medicineAir interventions are not able to adequately control fluid overload or high blood potassium levels.
Dialysis has been performed as a routine treatment of ESRD since the 1960s. The patient's blood slowly passes through a semi -permeable membrane that filters out and removes liquid, electrolytes and waste products and then returns to the patient. Unnatural electrolytes and waste products are at higher blood concentrations than in dialysis fluid and move from higher to lower concentration simple diffusion. Dialysis fluid is called dialysis and is prescribed for each individual patient by a doctor.
There are two main types of chronic dialysis: hemodialysis and peritoneal dialysis. Hemodialysis can be performed in a hospital, at a dialysis clinic or at home. The usual treatment schedule of hemodialysis in the US is three to five -hour sessions, three times a week. In some patients more frequent hemodialysis up to fivekr mayAt or six times a week to better check the ESRD complications.
During hemodialysis, the patient's blood flows through a diaphragm called a dialyzer and then returns to the patient. Less than one cup of blood is actually outside the patient's body in the dialysis machine at the moment. For chronic dialysis by this method, health care providers must be able to easily gain access to the patient's blood. This is usually done with an arteriovenous (AV) fistula, where the surgeon is connected to the artery and vein under the skin in the forearm to form a larger blood vessel.
Continuous outpatient peritoneal dialysis (CAPD) is another option for patients who need chronic dialysis. The patient perceives the dialysis into his abdominal cavity through the implanted catheter, allows the fluid to stay for several hours and then releases the dialyzant out. The peritoneal membrane, which contains many small blood vessels, acts as a dialysis filter. Capd Dialsate contains a lot of glucose that creates a concentration gradient that pulls out excessby water from the blood.
CAPD must be made four to five times a day. The advantage is that it is possible to do at home, at work or travel. However, it requires a very motivated patient to keep up with all daily exchanges. A related procedure, called continuous cycling peritoneal dialysis, can also be performed at home. This type of dialysis requires a machine that performs frequent replacements for 10 to 12 hours at night.
During the dialysis procedure, patients may experience low blood pressure, muscle spasms and itching. Over time, there is a risk of infection in AV fistula, which may require hospitalization. Patients who have been on dialysis for several years or more are threatened by amyloidosis. This is a condition caused by deposits of protein and tendons.
patients who receive any type of chronic dialysis have several requirements. It must be willing to follow a strict treatment plan to prevent the accumulation of fluids and undesirable electrolytes. In addition, they must limit or monitor theMemo fluids and monitor a special diet that limits proteins, sodium, potassium and phosphate. Most dialysis patients also take more drugs such as phosphate binders, erythropoetin and calcium/vitamin D.
If patients with ESRD are unable to receive kidney transplantation, chronic dialysis must be performed throughout their lives. It may seem that this is a cumbersome procedure, due to strict schedules and restrictions. Despite this, chronic dialysis can allow patients with ESRD to live for many years.