Dialysis |
Definition
A method of removing toxic substances (impurities or
wastes) from the blood when the kidneys are unable to do
so. Dialysis is most frequently used for patients who
have kidney failure but may also be used to quickly
remove drugs or poisons in acute situations. This
technique can be life saving in people with acute or
chronic kidney failure.
Alternative names
artificial kidneys; hemodialysis; AV graft; AV fistula;
peritoneal dialysis
Peritoneal
dialysis works by using the peritoneal
membrane inside the abdomen as the semipermeable membrane.
Special solutions that absorb toxins are infused in,
remain in the abdomen for a time, and then drained out.
Hemodialysis
works by circulating the blood through a
machine. The blood flows across a semipermeable membrane
with solutions that remove toxins. Before hemodialysis
can be performed, there needs to be adequate access to
the vascular system. The access needs to support a blood
flow of 250 milliliters per minute (ml/min), and a normal
venous peripheral IV will not support that volume of
blood flow. A special type of arterial and venous access
is therefore established.
The access can be either external or internal. External
access involves two catheters, one that is placed in an
artery, and one in an adjacent vein, then both are joined
externally. External access is typically only used in
emergency situations.
Internal access can be either an arteriovenous (AV)
fistula or AV graft. An AV fistula involves the surgical
joining of an artery and vein under the skin. The
increased blood volume stretches the elastic vein to
allow a larger volume of blood flow. After the 4 to 6
weeks the fistula needs to heal, needles can be placed so
that arterial blood can be pulled off for dialysis, and
the cleansed blood returns through the dilated vein.
Turbulent blood flow over the AV fistula is commonly felt
and termed a thrill.
An AV graft may be used for people whose veins are not
suitable for an AV fistula. This procedure involves
surgically grafting a donor vein from the patient's own
saphenous vein (in the leg), a carotid artery from a cow,
or a synthetic graft from an artery to a vein.
After there is adequate access with two ports, a
hemodialysis machine is connected; the port from the
artery leads into the machine, and the port returning
from the machine leads into the vein. Inside the machine,
your blood is run through tubes with semipermeable
membranes, and the tubes are bathed with solutions that
will remove specific soluble materials from your blood.
Since Hemodialysis takes several hours, it may become
tedious. With children it is especially important to have
games, something to read, or other distractions.
Risks |
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Immediate risks include:
Long term risks include:
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I myself have used both
dialysis systems,hemo and peritoneal. From my personnel point of view the peritoneal is much more easy to live with.Of course I realise it's not always evident and possible for everyone because you're in charge of everything,you must take all the responsibilities involved and once you have connected to the machine you lose your independence in more than one way,and some patients simply don't react well to the peritoneal. B'aruch H'ashem(thank G-D)I am blesses with two devoted parents who took a large part of the burden on them,and my sisters have been very helpful and supportive *as well. But if peritoneal is an option think of all the advantages peritoneal dialysis offers. a)You can work/attend school full time every day. b)The diet especially concerning consumption of fluid is less restricted c)if you live far from the dialysis center(like I do)you spend much less time getting stuck in traffic lines:) d)Well I feel like life is a whole lot easyer especially remembering the way I felt sometimes after hemodialysis. e)Well although it's 100 % ok,on Yom Toivim you don't have to drive to the Hemodialysis Center. I would love to hear your comments on the
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