Early risks of peritoneal dialysis catheters

From the beginning having to go to dialysis is already a big hit to the body and to the soul. In this process, catheter is inserted into the patient to have a healthier and more comfortable life. The thing is that the patients run some risks in the early stages of this procedure.

In this post we are going to explore a bit those early risks and how they manifest in the body.

Early complications are the ones that appear in the early months after inserting the catheter. Most of the times these complications arise because there was a mistake in the catheter implantation and they get worse with all the pressure made by content in the abdominal area.

Pain

A lot of patients say that the pain that comes with the procedure is deep due to the traction of the bowels and patients can feel pain right after the catheter procedure. Another source of pain comes from the dialysate solution. Here are three exact ways that pain appears in the first stage of the catheter: having a sensibility for the PH in the solution; the compartments where the catheter is inserted; the place where the catheter goes and has contact with many organs of the body .  

Bleeding

Bleeding can come from in two ways: when arteries in the abdominal area are affected which happens when the needle is inserted to the vessels in the blood. In this case only removing the needle or the strange agent in the body will be enough to stop bleeding. The other way is venous laceration that is more of a problem to detect because there are no muscles involved. For each case a fast-medical treatment is required and specific treatments for the vessels  be done.

Perforations

Perforation risk will always be present in the catheter procedure.  The alarms should go off if bleeding, mild to high level pain or peritonitis is observed and at the same time  if fluids and liquids are pushed back through the catheter or stylet and a bad smell is sensed. These symptoms can arise immediately and medical attention is enough to manage such perforations. But there are some patients that don’t show symptoms in the early stages and the diagnosis here becomes a bit more complicated.  If this diagnosis is done late the patient runs the risk of a serious perforation, obstruction or a renal illness and internal hernia.  This diagnosis can also become tricky because the perforations could be small and remain hidden for a while and the doctors associate this with a very good catheter insertion.

Obstruction

The most common obstruction is the one that comes from the fact that the catheter is very close to the intestine and has the infusion of the solution but does not allow much space for the outflow. All these risks of obstruction have to do directly with poor orientation of the catheter’s tunnel that in turn will result in affecting the abdomen due to the memory the catheter has.  

Hernia

This risk is very painful and dangerous. It may appear when they implant the catheter and there is an intra abdominal pressure. This risk is just the consequence of not having strong abdominal muscles. There are many things that can be done to correct this in the diagnosis stage. If not, the volume of the infusion should be reduced and the patient should be controlled until a new surgery is scheduled.

health-issues_dialysis

Image courtesy of Neon Tommy at Flickr.com

Hydrothorax

Hydrothorax comes from the fact that the muscles are not strong enough. This risk in not identified until later in the process. This makes it very dangerous as this will not be noticed only when fluid is present in the peritoneal cavity and there is a very high level of intraperitoneal pressure. Here women are at high risk, even more than men because all the fluid accumulates on the right side of the pleural cavity.  To identify this risk we can first see a dyspnea or an inadequate ultrafiltration but it is not immediate and it is not identified in the early stage unless there is an extra test like x-rays or a routine physical check.

Genital Edema

Edema means inflammation. One of the most seen causes for a genital edema is the peri catheter fluid extravasation into the preperitoneal space and a vaginal procedure.  

We have talked a lot about all the dialysis options that patients have. In this case, we just gave the public a series of risks that have to be taken into account when the patient is going to start his or her procedures with catheters. Sometimes the risks are not very well understood by the patients and here is where this post will help the people to more or less understanding, or to have an informed starting point, to understand what are the complications of certain procedures that involve the kidneys and that affect the rest of the body at a certain point.

Be sure to also read this post about how to make dialysis less tiresome

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Everything You Need to Know About A Dialysis Machine

As Joe Cosgrove has pointed out before in this blog, kidney plays a vital role in the functioning of the human body. Without them, the waste present in the blood couldn’t be removed, and most individuals would die within a few days. Sadly, these bean-shaped organs can fail and when that happens, the best option for patients is to go under dialysis.

Dialysis is a medical procedure that works as an artificial kidney. It takes place when a person’s blood is filtered with the help of a dialysis machine. This machine aims to mimic the regular functions of human kidneys. This way, it is able to remove toxic waste from the blood as well as the extra water that may be present in it.

dialysis_dialysis machine

Image courtesy of Matt Kowalczyk at Flickr.com

Each dialysis machine is built up in a similar way and healthcare providers and technicians know how to operate them in order to help patients filtering their blood. There is a list of parts and components that need to be well known by technicians in order to properly handle the dialysis machine. Below, you will find a list of these components with a brief description of each one of them.

Pumps

The most common type of pump used during dialysis is known as Peristaltic pumps. These are tubes meant to drive different fluids, such as blood, water, saline, and dialysate. This type of tubes is ideal for dialysis since they let a higher volume of fluids flow without letting them be touched by human hands. Also, dialysis pumps are a flexible system that helps to push fluids forward with the help of motors (AC or DC motors) which speed can be regulated by the technician.

Some pumps are connected to a sensory system that allows them to automatically regulate the flowing pressure of fluids depending on the patient’s needs. Nevertheless, in order to properly function, pumps need to be configured in advance based on the type of fluid that is going to pass through them

Valves

Dialysis machines need to have a few electronic valves to operate properly. This happens since dialysis machines need to use variable mixing ratios that are only possible when different valves open and close at different times. This type of valves are solenoids which can be controlled with precision thanks to the action of stepper motors or another mechanism.

Sensors

Most dialysis machines use different types of sensors. This happens because they need to monitor and regulate different parameters that take place during the dialysis procedure. Some of these parameters include motor speed, temperature, oxygen saturation, dialysate pressure, dialysate membrane pressure, and airflow.

Nowadays, dialysis machines usually have digital outputs that allow the technicians to know what is going on during the dialysis procedure. When they don’t have these digital outputs the signal sent by the sensors needs to be amplified and digitized before reaching the controller. In order to be more accurate, a series of ADC resolutions are used and the sampling speed varies.

Cleaning system

A dialysis machine can be used to treat many different patients. This is why it needs to be cleaned before each session and components that are going to be reused must be properly sterilized too. Each machine can be cleaned in a different way, but most of them have the same system.

Technicians need to heat water to high temperatures so it can sterilize the tubes and each part of the dialysis machine when it runs through them. The inner and outer circuit of the machine needs to be cleaned with that water by activating the cleaning mode of the machine. However, there are different types of machines that require this process to be monitored and controlled.

Syringe

The syringe is an external element used to pump substances into the dialysis machine. This procedure is needed since the blood tends to clog the machine’s pumps and a drug called heparin needs to be injected into the tubes to keep them unclogged. The syringe is attached to the pumps in most machines.

renal-dialysis-technician

Image courtesy of wistechcolleges at Flickr.com

Dialyzer

The dialyzer is probably the most important piece of the dialysis machine because it is where the blood is filtered. Here a filtering membrane and a cleaning solution called dialysate can be found. The dialyzer is, in general terms a blood compartment.

Dialysate Solution

The dialysate is a solution made of purified water, an acid and bicarbonate that can be found inside the dialyzer. It is meant to remove waste from the blood thanks to the action of the minerals and electrolytes present in the solution. Dialysate never mixes with the blood; it simply takes waste away with the help of a filtering membrane.

Once the blood is cleaned and filtered thanks to the combined action of both the dialyzer and dialysate, it is pumped back into the patient’s body. This process takes place in the form of a moving current since only one pint of blood can be treated at the time.