Dialysis as a third option

Failing kidneys can be treated through several options, in fact, Joe Cosgrove have previously discussed the alternative treatments whereby kidney failure can be handled; however, the most common treatment, as readers might have already guessed is dialysis. Dialysis is often considered by physicians and doctors as a the third option for treating kidney malfunction —dialysis replaces a function of the kidney with a special equipment commonly used to cleanse and filter the blood, where blood goes first through a dialyzer and then back to the body.


Image courtesy of Frank DiBona at Flickr.com

There are two basic types of dialysis: hemodialysis, which happens outside the body, and peritoneal dialysis, which happens inside the body. As mentioned before, the first type of dialysis (hemodialysis) occurs when a person’s blood is passed through an artificial kidney (called dialyser). As with many other conditions and treatments, patients who are to undergo dialysis need to change some habits, in this case, it is advisable for future patients to avoid drinking fluids in excess. This procedure is ordinarily done for four hours, three times a week, and requires access to the patient’s blood either through an intravenous line inserted in the patient’s neck or a fistula: a procedure whereby an artery and a vein are connected surgically on the arm. This normally can take up to three months to be ready as it requires prior assessment and a certain degree of planning. The perks of hemodialysis are that it can be done at home, even when patients are sleeping; nonetheless, it usually takes place at a hospital.


Image courtesy of wistechcolleges at Flickr.com

As for peritoneal dialysis, commonly known as PD, the procedure differs from hemodialysis as the blood is cleansed inside the body through a line carefully place in the inside of the abdomen—or peritoneum—: a tube is allocated close to the belly button inside the peritoneum whereby a solution, called dialysate solution, is carried to the inside of the abdomen and left there for a few hours. This dialysate solution is in charge of cleansing, or rather, diffusing the waste products out of the patient’s blood so that the fluids can re-enter the peritoneum (now cleansed) back again. This procedure is called an exchange and it usually takes 20 up to 30 minutes, and there are ordinarily two ways to perform it and the criterion for choosing one amongst the two variants depends upon the timing of the exchanges — Continuous Ambulatory Peritoneal Dialysis (or CAPD) typically entails four exchanges which patients can do themselves every day using dialysis bags for it. It has some advantages in comparison to hemodialysis since patients can move between exchanges about as normal. Automated Peritoneal Dialysis (or APD) is the procedure where a machine that patients can easily set up just before going to bed performs the exchanges for them at night for usually seven to ten hours. Patients might feel some discomfort once they wake up but certainly will be able to move about as normal as well.

Now that both types of dialysis have been explained, patients should focus on deciding where they want to undergo this treatment, whether at a hospital or at home. There are some obvious advantages of choosing a clinic over home. During dialysis at home, patients require the ability to self-manage themselves and will eventually lead them to learn new skills related to self-caring themselves and problem-solving; however, there are also certain conditions that might make the process of self-caring reliably much harder than initially thought: alcohol, or drug addiction, or cognitive impairment, or another medical condition, or psychological predisposition. This process can be at first a daunting task if patients do not have a reliable helper. Additionally, people who have had various abdominal surgeries or procedures are likely not to be eligible for peritoneal dialysis. In order for patients to easily assess whether they will be able to overcome the challenges commonly associated with having dialysis at home, physicians have agreed upon the fact that, if patients are able to manage and use an ATM machine, or have the dexterity to button a shirt, then it would be fair to assert that they also will be able to manage home dialysis.

There are a few factors that might also lead patients to choose home dialysis over hospitals and clinics: they might live far away from a dialysis clinic, or maybe they feel that they will not be able to comply with the diet and fluids restriction mandatory for this procedure to be effective. Actually, most people end up choosing peritoneal dialysis for personal reasons where the #1 reason is the degree of flexibility and the degree of control they can attain at home. People often perceive that undergoing peritoneal dialysis at home enables them to attain a much higher level of self-management and control, without mentioning the fact that they will not be traveling to a clinic several times a week.


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