What is dialysis and who needs it

What is dialysis

Dialysis is a method of purifying the blood from harmful substances and excess fluid using a special hypertonic solution. It contains electrolytes, as in blood plasma, as well as a high concentration of glucose. During the procedure, such a solution is placed on one side of the semi-permeable membrane, and blood on the other. As a result, glucose draws water from the blood with uric acid, small proteins and other toxic substances dissolved in it.

In a healthy person, the kidneys are involved in this filtration of blood and the production of urine. This occurs in the choroid plexuses (glomeruli). But when they are damaged, metabolic products, electrolytes and other compounds accumulate in the body. If all this is not removed with dialysis, the person may die.

Who is dialysis

Most often, the procedure is prescribed for chronic renal failure, which can develop for various reasons Hemodialysis. Here they are:

diabetes;
arterial hypertension;
glomerulonephritis, or immune inflammation of the kidneys;
vasculitis - vascular inflammation;
polycystic kidney disease - the formation of a large number of cavities with fluid in them.

Sometimes dialysis is required Dialysis - hemodialysis in acute renal failure. This condition of Acute kidney failure develops rapidly, within two days. It can be associated with drug or drug poisoning, shock due to burns, blood loss or sepsis, or blockage of the urinary tract by a stone or kidney vessel with blood clots.

The main criterion for Dialysis - hemodialysis, which the doctor is guided by when prescribing dialysis, is a decrease in kidney function to 10-15%. To determine this, an analysis of the glomerular filtration rate is done. The study shows how the small vessels of the kidney pass various substances through them.

What dialysis can be

The procedure is carried out in two main ways of Dialysis:

Hemodialysis. To purify the blood, a special apparatus with a thin membrane is connected to the vessels on the human hand.
Peritoneal dialysis. In this case, the patient's own peritoneum is used as a filter. There are many small vessels in it, so a hypertonic fluid poured into the abdomen will draw water and toxic substances from the blood.

What are the risks of dialysis?

Any method of cleansing the blood can cause Side effects - Dialysis to feel tired and fatigued. Perhaps more of this is due to the kidney disease itself.

In addition, each dialysis method has specific complications. In hemodialysis, these are Side effects - Dialysis:

Low blood pressure. This is due to a sharp decrease in the level of fluid in the vessels during the procedure.
Blood poisoning, or sepsis. It develops when bacteria enter the bloodstream.
Muscle cramps. This complication also appears due to fluid loss.
Itchy skin. It gets worse between dialysis treatments.
More rare side effects. These include insomnia, joint pain, decreased libido, dry mouth, and anxiety.

Peritoneal dialysis has fewer Side effects - Dialysis complications. It can cause peritonitis, an infectious inflammation of the abdominal cavity. Also, people who are prescribed such a procedure have an increased risk of developing a hernia of the abdomen.

How is dialysis done

The technique depends on which method of blood purification was recommended by the doctor.

Hemodialysis

First you need to prepare for the procedure, and it may take several weeks or months for Hemodialysis. To do this, the surgeon will perform an operation on the vessels to which the device will be connected. There are three options for Hemodialysis intervention:

Creation of an arteriovenous fistula. This is the safest way. On the arm, which a person uses less often, an artery and a vein are connected.
Arteriovenous transplant installation. If the vessels are too small to make a fistula, they are connected with a flexible synthetic tube.
Central venous catheter insertion. This method is used in emergency cases when there is no time for planned preparation. To do this, a temporary tube is inserted into a large vein under the collarbone or in the groin.

When the postoperative wound heals, proceed to the procedure. Hemodialysis can be done at home using a portable machine or in a hospital. For some people, Hemodialysis is done two or three times a week for 5-6 hours. Sometimes dialysis is performed daily, but for 2-3 hours.

Before starting the procedure, a person is weighed, his blood pressure, pulse and temperature are measured, and he is placed in a chair. Cleanse the skin around the access point with an antiseptic. Two needles are inserted into the vessels. The first is in an artery from which blood is sucked into the apparatus. Filtration takes place there. Then, through a second needle - in a vein - the purified blood is returned to the body. During hemodialysis, fluctuations in fluid levels in the body can cause discomfort, pressure surges, nausea and abdominal cramps.

After the end of the procedure, the needles are removed, the skin is sealed with a sterile plaster, and the person is weighed again.

Peritoneal dialysis

Dialysis also needs to prepare for it. To do this, an incision is made on the skin near the navel, into which a thin tube is inserted - a catheter. After the operation, it takes 10-14 days for the wound to heal. The tube remains in place for as long as dialysis is needed. Through it, a hypertonic solution will be injected into the abdominal cavity.

Further actions depend on the method of cleansing. There are two Dialysis - peritoneal:

Continuous ambulatory peritoneal dialysis. In this case, the stomach is filled with a solution. Then he can go about his business, since it is not required to connect to any device. After 4-6 hours, this liquid is drained. This will have to be done three or four times a day.
Continuous cycle peritoneal dialysis. The patient is connected to a special device at night, which pours dialysis water into the abdomen and removes it. During sleep, three to five such cycles pass.

How long does dialysis take?

This procedure does not heal the kidneys, it only helps the body purify the blood. Therefore, the duration of Dialysis dialysis depends on the reason for which it was prescribed. If health has deteriorated for a while, for example, due to poisoning or burns, then after the restoration of the body, cleansing is no longer needed. And with chronic kidney failure, dialysis can only be stopped when a kidney transplant is done.