Dialysis is a medical procedure that helps perform the function of the kidneys when they are unable to adequately filter waste products and excess fluid from the blood. It is commonly used in patients with end-stage renal disease (ESRD) or severe kidney dysfunction. Dialysis helps maintain the body’s balance of electrolytes and fluids, preventing the buildup of harmful substances in the bloodstream.
Treatments
There are four main types of dialysis treatments:
- Tunneled catheter: A tunneled dialysis catheter is often used for temporary dialysis access. The catheter is placed in a vein in the neck and is routed under the skin, where the catheter exits the skin near the chest or shoulder.
- AV Fistula: An AV (arteriovenous) Fistula is often considered the best option for dialysis access since rate of infection is low, it is longer lasting, and is less likely to clot. An AV Fistula is created when the surgeon takes a piece of a pre-existing vein from the patient’s arm or leg and sews it to a nearby artery.
- AV Graft: Similar to a fistula, an AV Graft is often placed in the arm, the main difference being that an AV graft is a synthetic tube that connects the artery and vein. This tube connection operates as a vein cand carries blood through the access. AV grafts are safe and effective if a fistula is not a good option, however grafts do have a higher rate of infection since they are not formed from natural tissue, and develop an increased risk of clots.
- Peritoneal Dialysis (PD): For eligible patients, a small tube is placed in the abdomen to allow the use of the lining of the abdomen to filter the blood. A connection to a specific solution through a catheter filter through the blood stream several times a day to exchange and discard the level of toxins in the bloodstream.
Before the Procedure
Before starting dialysis, a thorough evaluation is performed to assess the patient’s kidney function, overall health, and suitability for different dialysis modalities. The care team will educate the patient about the procedure, discuss the advantages, risks, and complications, and assist in making an informed decision.
During the Procedure
- Hemodialysis
- Vascular Access: Before each session, a vascular access site is prepared, typically through an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous catheter (CVC).
- Dialysis Session: The patient is connected to a hemodialysis machine that pumps blood through the dialyzer, which acts as an artificial kidney. The dialyzer filters waste products and excess fluids from the blood, and the clean blood is returned to the body.
- Peritoneal Dialysis:
- Catheter Placement: A catheter is surgically placed in the abdomen, allowing for the introduction and removal of dialysis solution.
- Dialysis Exchange: The patient performs dialysis exchanges at regular intervals, typically four to six times a day. The dialysis solution is introduced into the abdomen, dwell time allows for waste and fluid removal, and then the solution is drained.
After the Procedure
After each dialysis session, patients may experience some fatigue or minor discomfort, which usually resolves within a short time. Following the procedure, it is important to monitor weight, blood pressure, and overall health. The healthcare team will provide guidance on fluid and dietary restrictions, medication management, and regular follow-up appointments.
Advantages
- Maintains Fluid and Electrolyte Balance: Dialysis helps remove excess fluid and electrolytes from the body, preventing complications associated with their imbalance.
- Removes Waste Products: Dialysis eliminates waste products that accumulate in the blood as a result of impaired kidney function, improving overall well-being.
- Provides Life-Sustaining Treatment: Dialysis helps prolong and improve the quality of life for individuals with end-stage renal disease.
Risks and Complications
- Infection: Infection at the catheter or access site is a potential risk.
- Hypotension: Low blood pressure may occur during or after hemodialysis.
- Muscle Cramps: Muscle cramps may occur during dialysis, often due to fluid and electrolyte shifts.
- Anemia: Dialysis may require additional medications to manage anemia.
- Access Complications: Problems with vascular access, such as infection, blockage, or narrowing, can occur.
Typical Recovery Time
Dialysis is a lifelong treatment for individuals with kidney failure. The frequency and duration of dialysis sessions depend on the specific treatment modality, the patient’s condition, and the healthcare provider’s recommendations.
Results and Post-Procedure Care
Dialysis effectively helps manage the symptoms and complications of kidney failure, providing individuals with a better quality of life. Post-procedure care involves:
- Regular Dialysis Sessions: Consistent attendance and adherence to the prescribed dialysis schedule are essential for optimal outcomes.
- Medication Management: Patients may require medications to manage blood pressure, anemia, and other complications associated with kidney failure.
- Dietary Guidelines: Following a kidney-friendly diet, which restricts certain foods and fluids, is important for maintaining fluid and electrolyte balance.
- Monitoring: Regular monitoring of blood pressure, laboratory values, and overall health is necessary to ensure the effectiveness of dialysis and detect any potential complications.
If you have specific concerns about a procedure or your health, please consult a physician.