The word dialysis comes from the Greek and means dissolution, as it is a process in which excess waste material, toxins, and water are removed from the blood in order to help the liver maintain its functions within the body. As we already know and have discussed previously here on Joe Cosgrove’s blog, the kidneys perform an important and exhausting task maintaining the balance of bodily fluids, minerals and all the acidic byproducts of metabolism that cannot be excreted through respiration. This importance is what makes a procedure like dialysis as necessary and integral to maintaining the health of patients with acute kidney failure in order to improve their quality of life and wait until they receive a transplant if that is their case.
Dialysis comes in different types and sometimes patients have a say into which kind of treatment is best for them, considering their own particular medical and personal factors. It is important to understand that no matter which type of treatment you use, your lifestyle will somehow be affected by the procedure, so it is a matter of finding what is best for you and best suits your daily activities.
There are five different types of dialysis, three of them are considered primary treatments (hemodialysis, peritoneal dialysis, and hemofiltration) and the other two are what are known as secondary methods (hemodiafiltration and intestinal dialysis).
Hemodialysis is a process of dialysis in which blood is extracted from the body and passed through a machine that cleans it before returning it back into the patient.
The process begins by extracting the blood through a catheter, an arteriovenous fistula or an AV graft. Out of those three extraction methods, the fistula is the preferred procedure because of their lower infection rates; their higher rates of blood flow and lower occurrences of thrombosis. From there, the blood is pumped into a machine where it mixes with a substance called dialysate. Both the blood and the dialysate meet inside the dialyzer where the toxins of the blood are filtered through diffusion. Diffusion in a molecular process in which particles go from areas of high concentration into areas of lower concentration; think about adding milk to your coffee and how the milk slowly begins to mix into the substance giving the tan color a latte is known for. Diffusion happens through a semipermeable membrane and then the used dialysate is flushed through one side and the clean blood is injected again into the body.
The process happens over and over during the whole session, with the blood being pumped into the body to help it extract more waste material to be filtered inside the dialysis machine. An entire session of hemodialysis can last anywhere from 3 to 4 hours in order to be effective and it is repeated about 3 times a week. With the exception of the needles going inside the veins, the procedure is painless but some other side effects including nausea, headaches, fatigue and low blood pressure can be present if the fluids are removed from the body too quickly, and while the patient gets used to the treatment. Most complications with dialysis are very rare, but considering the circulatory system is being constantly exposed to treatment, it is possible for some patients to face some complications with infections depending on the extraction method being used.
Peritoneal Dialysis is a process in which the cleaning process of dialysis takes place inside the body of the patient as opposed to using an external machine to complete the procedure. Just like in other processes like hemodialysis in which an artificial membrane is used to filter the blood, here the membrane used is the peritoneum itself.
Using a catheter, a sterile solution of dialysate is inserted into the abdominal cavity where it will mix with body fluids and become saturated with waste material by diffusion. Later, this liquid is removed out of the abdominal cavity, thus helping the body get rid of excess toxins. The process is repeated four or five times everyday. Peritoneal Dialysis is gentler but not as effective as hemodialysis and because of that it must be repeated daily, usually by patients themselves that have been properly taught on how to go about the procedure. Complications in peritoneal dialysis may arise when the body retains more fluid than in should after the procedure or if too much of it is removed. Pain and discomfort as expected if the dialysate is too cold or inserted too quickly into the abdomen. Continuous Ambulatory Peritoneal Dialysis can be done during the day as the person goes about their daily life while Automated Peritoneal Dialysis uses a machine that makes the fluid exchange as you sleep at night, leaving a reduced amount of the solution inside the body during the day.
Understanding the different processes is of great importance for you to take charge of your health and make the best decisions concerning your condition along with your physician.