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What Is The Purpose Of Dialysis In Kidney Disease

More Information About Dialysis

How dialysis works

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • Suggested Foods for Dialysis Patients: The American Association of Kidney Patients provides this comprehensive list of acceptable foods, grouped by category, for patients on dialysis.

Doing An Exchange By Hand

  • After you wash your hands and put on your surgical mask, drain the used dialysis solution from your belly into the drain bag. Near the end of the drain, you may feel a mild tugging sensation that tells you most of the fluid is gone. Close the transfer set.
  • Warm each bag of solution to body temperature before use. You can use an electric blanket, or let the bag sit in a tub of warm water. Most solution bags come in a protective outer wrapper, and you can warm them in a microwave. Dont microwave a bag of solution after you have removed it from its wrapper.
  • Hang the new bag of solution on a pole and connect it to the tubing.
  • Remove air from the tubesallow a small amount of fresh, warm solution to flow directly from the new bag of solution into the drain bag.
  • Clamp the tube that goes to the drain bag.
  • Open or reconnect the transfer set, and refill your belly with fresh dialysis solution from the hanging bag.

Are There Alternatives To Av Fistula

AV fistula is the best way to receive dialysis because its a long term solution for dialysis patients and carries a low risk of infection. However, there are several alternatives worth considering. If you do not have a vein of sufficient size for an AV fistula, an artificial vein may be installed via AV bypass graft surgery. If immediate dialysis is required, a dialysis catheter can be inserted in a vein until a longer-term solution is created. At Yale Medicine Vascular & Endovascular Surgery, our surgeons are dedicated to finding the best dialysis access option for you.

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Capd Doesnt Use A Machine You Do The Exchanges During The Day By Hand

You can do exchanges by hand in any clean, well-lit place. Each exchange takes about 30 to 40 minutes. During an exchange, you can read, talk, watch television, or sleep. With CAPD, you keep the solution in your belly for 4 to 6 hours or more. The time that the dialysis solution is in your belly is called the dwell time. Usually, you change the solution at least four times a day and sleep with solution in your belly at night. You do not have to wake up at night to do an exchange.

Use A Transfer Set To Connect Your Catheter To The Dialysis Solution

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A transfer set is tubing that you use to connect your catheter to the bag of dialysis solution. When you first get your catheter, the section of tube that sticks out from your skin will have a secure cap on the end to prevent infection. A connector under the cap will attach to any type of transfer set.

Between exchanges, you can keep your catheter and transfer set hidden inside your clothing. At the beginning of an exchange, youll remove the disposable cap from the transfer set and connect the set to a tube that branches like the letter Y. One branch of the Y-tube connects to the drain bag, while the other connects to the bag of fresh dialysis solution.

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When Is Dialysis Needed

Dialysis is most often required due to kidney failure.

Kidney failure can sometimes happen over a short period this is called acute kidney failure as the result of a serious illness or accident.

More commonly, kidney failure is the result of chronic kidney disease, where kidney function worsens over many years. Dialysis is usually started when the person affected is finding it hard to keep up with their usual life. At this stage, the kidneys are usually working only about 10% of how they should be working.

Dialysis must be done for the rest of your life, unless you have a kidney transplant.

What Happens Before Peritoneal Dialysis

About three weeks before you start peritoneal dialysis, youll have a minor surgical procedure. A surgeon inserts a soft, thin tube through your belly and into the peritoneum. This catheter stays in place permanently.

A healthcare provider will teach you how to perform peritoneal dialysis at home and prevent infections at the catheter site.

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Is Kidney Failure Permanent

Usually, but not always. Some kinds of acute kidney failure, also known as acute renal failure, get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys get better.

In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney.

What Is Peritoneal Dialysis And How Does It Work

What is Chronic Kidney Disease and how does dialysis work?

In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen to make an access. During the treatment, your abdominal area is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis.

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What Is The Purpose Of Kidney Dialysis

The main purpose of kidney dialysis is to perform the function of the kidneys, artificially, using a machine. People usually go for kidney dialysis when they are suffering from a critical condition like end-stage renal disease . In this situation, the kidneys are completely damaged and can no longer do what they are supposed to do. In haemodialysis, the dialysis is done by inserting a needle into the blood vessel, the needle already being attached to the dialysis machine with the help of a tube.

Once that is done, the blood is transferred from the blood vessel and stored into the dialysis machine where it is filtered. Once the waste materials and fluids have been extracted, the filtered blood is again sent back to the body. This is considered to be the most commonly used technique for kidney dialysis. The other type of approach is known as the peritoneal dialysis wherein the blood is filtered using the peritoneum membrane inside your abdomen.

The replacement fluids helps in balancing the electrolytes lost in the process. And last but not the least, the other type of approach is known as the hemodialfiltration, which is a combination of hemodialysis and hemofiltration.

Using A Cycler For Automated Peritoneal Dialysis Exchanges

In automated peritoneal dialysis, you use a machine called a cycler to fill and drain your belly. You can program the cycler to give you different amounts of dialysis solution at different times.

Each evening, you set up the machine to do three to five exchanges for you. You connect three to five bags of dialysis solution to tubing that goes into the cyclerone bag of solution for each exchange. The machine may have a special tube to connect the bag for the last exchange of the night.

At the times you set, the cycler

  • releases a clamp and allows used solution to drain out of your belly into the drain line
  • warms the fresh dialysis solution before it enters your body
  • releases a clamp to allow body-temperature solution to flow into your belly

A fluid meter in the cycler measures and records how much solution the cycler removes. Some cyclers compare the amount that was put in with the amount that drains out. This feature lets you and your doctor know if the treatment is removing enough fluid from your body.

Some cyclers allow you to use a long drain line that drains directly into your toilet or bathtub. Others have a disposal container.

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How Do I Prepare For Hemodialysis

Dialysis is a complex treatment that takes time to understand. Because most people dont feel sick until shortly before starting dialysis, youll likely still feel well when your doctor first talks to you about getting ready for dialysis. No one wants to start you on dialysis before you need it, but it takes time to prepare for dialysis.

Reasons For Dialysis In Kidney Failure

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Doctors decide to place a person on dialysis when kidney failure is causing certain conditions:

  • Abnormal brain function

  • Certain other severe symptoms, such as loss of appetite or vomiting and weight loss

  • Greatly reduced kidney function

Occasionally, another technique is used to temporarily filter the blood and accomplish what dialysis would. These techniques are most often used if dialysis cannot be done, to remove the poisons from the blood, or to remove large amounts of fluid in some people who have acute kidney injury.

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How Does Dialysis Machines Actually Work

To help you understand even better, heres a general step-by-step explanation of how a typical dialysis machine works.

  • Through a vascular access that is placed in the patients body by minor surgery, blood is removed and enters the dialysis machine.
  • The blood flows through a dialysis tubing, a semipermeable membrane that contains pores large enough to allow diffusionthe movement of a substance from an area of high concentration to an area of low concentration.
  • A blood thinner may be prescribed to keep ones blood from clotting while going through the dialysis machine.
  • A pump and an arterial pressure monitor work hand-in-hand in keeping the blood flow at a right rate.
  • The blood enters the dialyzer.
  • A dialysate enters the dialyzer. Also called a dialysis solution, this is a fluid made up of water, electrolytes, and salts. Dialysate helps in cleaning up the blood by pulling out the waste products that are in it. How does this work? Through the process of diffusion. A renal patients blood contains a high concentration of toxins, while dialysate contains a low concentration of toxins. Because of this difference, diffusion takes place wherein waste and excess fluids move from the blood across into the dialysate, creating an equal amount on both fluids.
  • The used dialysate is pumped out of the machine and discarded. While the blood goes through another arterial pressure monitor and air trap to ensure that its safe to return into the patients body.
  • What Dialysis Can And Cannot Do

    Many people assume dialysis replaces the function of healthy kidneys. This is partially true. The primary job of the kidneys is to remove excess fluid and waste from the bloodstream. When your kidney function is below 15 percent of normal, you need dialysis to filter these items from your blood. But your kidneys have other duties as well. They make and release hormones that regulate and control certain body functions. Unfortunately, dialysis is unable to manufacture these essential hormones. Patients in the later stages of chronic kidney disease will need medical supplements to compensate for the hormones their kidneys are unable to produce.

    Dialysis removes fluid and wastes

    The main purpose of dialysis is to replace impaired renal function. When your kidneys are damaged, they are no longer able to remove wastes and excess fluid from your bloodstream efficiently. Waste such as nitrogen and creatinine build up in the bloodstream. If you have been diagnosed with CKD, your doctor will have these levels carefully monitored. One of the best indicators of kidney function is your glomerular filtration rate . Your GFR tells your doctor how well your kidneys are filtering waste from your blood.

    If your GFR level is below 15, dialysis becomes necessary. Before dialysis, patients often felt weak and ill. Dialysis brings relief from these symptoms. This is the primary benefit of dialysis.

    Dialysis helps regulate electrolytes

    Dialysis cant replace hormones

    Summary

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    How Should Hemodialysis Patients Begin To Plan A Trip

    Many dialysis centers have a staff member who is experienced in arranging dialysis treatments away from home . Some centers will assist patients in making their own arrangements. Ask your social worker or primary nurse if there is such a person at your center.

    It is important to start planning at least six to eight weeks in advance. More time should be allowed for popular vacation spots or travel during holidays. Be flexible about the dates for your trip as space in dialysis units may be limited. If you would prefer to have your treatments on specific days and at specific times, let the center know in advance. The unit may not always be able to honor your request, however, because space is limited.

    You or your patient travel coordinator may need to contact more than one center in order to find a center that can provide dialysis for you. Check with the center as soon as you arrive to confirm your appointment. You may also want to visit the center and meet the staff so you will feel more comfortable. Before doing this, however, make an appointment with the social worker or nurse manager of the dialysis center you plan to visit.

    What Happens During Hemodialysis

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    During hemodialysis, the dialysis machine:

    • Removes blood from a needle in your arm.
    • Circulates the blood through the dialyzer filter, which moves waste into a dialysis solution. This cleansing liquid contains water, salt and other additives.
    • Returns filtered blood to your body through a different needle in your arm.
    • Monitors your blood pressure to adjust how fast blood flows in and out of your body.

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    Will I Have To Take A Physical Exam

    The ADA states that your employer may not ask you to take a physical exam until after a job offer has been made and only if all the applicants for that job are required to take a physical exam. If the job offer is taken back after you have the exam, the company must show that you cannot perform the essential functions of the job. You can be asked to take a drug test.

    Q: What Are The Types Of Renal Dialysis

    A: There are two types of renal dialysis: haemodialysis and peritoneal dialysis.

    Both types involve the process of removing wastes and excess fluids from the blood. The main difference is that haemodialysis makes use of an artificial kidney machine to clean the blood, while peritoneal dialysis uses the lining in the bodys abdomen to facilitate the filtering process.

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    What Does Dialysis Do

    When the kidneys can no longer function optimally, dialysis works to do their job artificially. Namely, dialysis treatment manually filters the waste and water from your blood. In the process, it helps control functions in your body that your healthy kidneys otherwise would.

    Kidneys help your body in many ways, including:

    • Maintaining safe levels of electrolytes, like sodium and potassium
    • Assisting making red blood cells
    • Keeping bones healthy
    • Controlling your blood pressure

    Dialysis can help people whose kidneys are failing be more comfortable and live longer however, it is not a cure for kidney failure.

    More Facts About Dialysis:

    Different Stages of Kidney Failure

    Dialysis is time-consuming, but most patients dont experience any pain other than minor discomfort when needles are inserted during hemodialysis. People undergoing dialysis usually feel better because the symptoms they experience from kidney disease are lessened.

    And while dialysis is expensive, the federal government, private health insurance and Medicaid programs will help you pay for treatment.

    Unfortunately, dialysis will not cure kidney disease. Life expectancy for patients on dialysis is usually about five to ten years, but some patients have gone on to live up to 30 years from the start of their treatment.

    While there is no cure for kidney disease, there are ways to prevent the chronic disease. The most important things you can do are keep your blood pressure, blood sugar and cholesterol under control. Some researchers have hope that alternative treatments like klotho therapy may one day help prevent kidney disease, too.

    If youre suffering from kidney failure, you and your doctor are likely already discussing dialysis treatments or a kidney transplantor both. Dont be afraid to ask questions and find a good support group.

    If youre worried about your kidneys or think you might be at risk for CKD, your healthcare provider can offer you personalized tips on how to keep yourself as healthy as possible.

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    Is It Possible To Travel If You Are Active On A Transplant Waiting List

    Yes. Simply inform your transplant coordinator about your travel plans. The coordinator will help you decide whether to be “on hold” during the trip or whether you would be able to return within a reasonable amount of time if a kidney became available. Arrange to be contacted in the event a kidney becomes available.

    What Are The Advantages Of The Different Types Of Dialysis

    Each of the two types of dialysis, hemodialysis and peritoneal dialysis, has advantages and disadvantages. It is up to the patient and their kidney doctor to decide which of these procedures is best by considering her/his life style, other medical conditions, support systems, and how much responsibility and participation in the treatment program he/she desires. The patient must realize that because of their specific medical condition, they may not be a candidate for one or the other type of dialysis. Each patient must view the two types of dialysis procedures from her/his own perspective.

    Regardless of which type of dialysis is chosen, patients have certain responsibilities such as following a diet program, watching their fluid intake, taking special vitamins, and other medicines to control blood pressure and calcium and phosphorus balance.

    For many patients, the major advantage of hemodialysis is minimal participation in the treatment. However, patients are required to adhere to a specific schedule and travel to the dialysis unit three times a week. Hemodialysis also requires stricter diet control and fluid control than peritoneal dialysis.

    For those patients preferring more independence, peritoneal dialysis allows for more flexible scheduling and can be performed at home. The patient must undergo a certain amount of dialysis each day, but can alter the exact timing of the dialysis procedure.

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