What is Peritoneal Dialysis, and which are the available treatments?

Peritoneal Dialysis (best-known as PD,) involves the removal of extra waste products from your blood. In this mode of dialysis, unlike other treatments, such as hemodialysis, the process is performed inside the body. This is a point that grabs the attention of many patients suffering from kidney disease, as it offers more practical conveniences. In contrast to hemodialysis, peritoneal dialysis is performed every day (just the way the kidneys work), and it is the patient who carries it out.

From the medical point of view, it is an advantage that this procedure is performed every day of the week because the blood stays cleaner and it is actually easier to prevent eventual crises. People do not have to wait to go to the hospital or to connect to the machine at home. All that is needed is a catheter which is inserted into the patient’s belly (and by a rather rapid procedure.)

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In reality, there are two types of peritoneal dialysis. The best-known is continuous ambulatory peritoneal dialysis (CAPD.) In this case, the catheter is connected to a tube, and through it, a cleaning liquid is introduced to start the waste elimination process, such as salts and excess of water in the blood. The cleansing fluid enters and is installed throughout the patient’s abdomen in less than a quarter of an hour, and then the patient’s abdomen lining begins to filter the disposable substances. At the same time, it retains nutrients and other necessary elements for the proper functioning of the organism. The introduction of the liquid should be performed under conditions of total asepsis, as an infection in these circumstances would be very serious and difficult to treat. In case of poor hygiene, peritonitis may occur. Peritonitis occurs when germs enter the peritoneal cavity through the catheter. It may be treated with antibiotics, but the performance of a treatment is extremely urgent. However, if the patient follows the medical recommendations, he or she will have no problem at all.

Recommended: The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients

The cleansing liquid (dialyzer) is left in the patient’s womb for an average of four hours so that the filtration can be effected smoothly. Obviously, each body is different, and, depending on the physiological characteristics, as well as the level of presence of noxious substances to be filtered, it remains more or less time. This treatment offers a lot of freedom since while the dialysis is taking place the patient can do everything that a normal person would do, without having to sit or lie next to a machine for hours. This is carried out in the most natural way possible: Thanks to gravity. It is not necessary to artificially suck the solution, and the patient simply replaces the liquid by the same procedure as it is mentioned above. When the dialysate has done its work, the solution containing all the residues (normally filtered by a kidney) is drained and expelled. The process is then repeated because the functions of the body do not stop, and it is repeated permanently. Hence, its name.

The other procedure is automatic. In this treatment, the patient connects the catheter to a machine, and this catches up with everything. The patient does not need to perform the exchange of new dialysate per used: It is an automatic process that even offers more freedom to patients. The machine works by cycles, like a washing machine. The patient schedules the machine at night, before going to bed, and the rest of the process is performed while the patient is resting. The interesting thing is that this machine is a totally independent equipment that works without connecting it to the drainage or the electricity. The cycling machine is not large, and, therefore, it is easy to transport, in case the patient should travel and carry it in the luggage. That is certainly another advantage.

The Merck Home Manual of Medical Information - Dialysis

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It is important to keep in mind that this treatment takes more time (overnight, to be precise.) The patient lies down to sleep, and seven or eight hours later, the machine will have cleaned the whole body. Manual functions in this process are minimal, and, in some cases, simply non-existent.

No matter what your choice is for the peritoneal dialysis procedure when it comes to the number of times the dialysis process is performed per day, it is the very same thing. In both cases, it is permanent. The only difference is that in the first one is done manually, while in the second one it is carried out by a machine. In both procedures, insertion of a catheter into the patient’s belly is necessary, and, again, it is not a complicated operation.

These are very good options for patients with kidney failure and are a sign that it is possible to follow a normal life. I hope this information has been helpful to you, and I hope you share it with your friends, especially those who you know need these treatments.

Read also: The Most Common Questions Patients Have About Dialysis, by Joe Cosgrove

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Coming Back From Kidney Disease: Are You Ready to Work Again?

As per discussed in older posts by Joe Cosgrove, kidney disease, and renal failure, although imply a really hard time for patients, still leave room for them to get the most out of life. One of the biggest issues that concern the vast majority of renal failure and dialysis patients is whether or not they are able to work and perform their old labor duties.

As a matter of fact, many people with chronic kidney disease or renal failure manage to work either full time or part time. Moreover, some of them even go to school or are able to take care of their families and homes. Others prefer to perform volunteer work while still enjoying their hobbies: they go out with peers or even have regular workout and exercise routines. But since these types of conditions come with a heavy burden for those who suffer from them, it is no less than understandable to see patients wondering about whether or not they are ready to work.

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Here are some of the questions that patients ask the most about the possibility continuing to work while on treatment or suffering from any type of kidney disease:

I had a job prior to suffering kidney disease. Can I go back to work?

Most patients, especially those who start dialysis or undergo a transplant want to go back to work almost immediately. Some assert that it helps them feel like they are getting their lives back to what they consider normal, whereas others may take some time to recover from the fallout of the treatment or the post-operatory in case they underwent a kidney transplant surgery.

I am currently employed, can I just continue working while on treatment?

Some dialysis patients manage to work full time soon after they start the treatment. Others, due to the nagging consequences of the treatment, decide to rather take either a part-time or remote work. What seems to be clear, is that dialysis patients prefer to take jobs that are not as physically demanding as their older ones. In fact, working from home with a flexible schedule seems to be the best option, as patients are required to go to hemodialysis from time to time.

Whichever the case, patients should be able to talk to their employers about possible changes and conditions that can help them continue working while on treatment. And this is particularly important since employers likely ignore what kidney disease is about and its implications, therefore, addressing concerns about the job is perhaps the wisest thing to do.

As a matter of fact, doctors are often willing to talk to the patient’s employer to explain and address their condition. Employers will obviously have concerns about the possible limitations, which is why having the doctor address these concerns really come in handy.

Am I protected against labor discrimination?

There are several acts that protect people with some kind of disability from labor and job discrimination. Being fired or being denied a promotion due to some kind of condition or illness is entirely protected by the Civil Rights Act, the Rehabilitation Act and the American with Disabilities Act.

Employers often ask for medical certification stating that the patient indeed suffers from a specific condition, and cannot under any circumstances fire or force employees to resign simply because they require surgery or treatment.

How do I know if I am ready to work?

Of course, health should always be the patient’s top priority. Prior to recklessly going back to work—ignoring medical recommendations—, patients must decide whether they feel physically and mentally strong to take on their duties again. This process, of course, should always be accompanied by medical rehabilitation.

People with kidney disease or renal failure often go through the following rehabilitation process: first, they need to get themselves back to a much healthier physical overall state; second, they have got to convince themselves that, although they suffer from these diseases, there is still room for positivity; third, they need to start feeling confident and ok around peeps, coworkers and relatives; and fourth, they need to learn how to self-manage themselves to regain their productivity.

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As previously recommended, accompanying rehabilitation with physical activity is tremendously beneficial and will help patients achieve the aforementioned goals much easier. Volunteering and helping other go through the same process also provides a sense of productivity and will definitely help them gain back the skills that could unquestionably help them get a job in the future. The whole idea is to not let the disease impair the patient’s mental state, for, although these conditions imply difficult times, the spirit is everything. There is always another opportunity and there is always a chance to get the most out of life even while on dialysis or treatment: imagination and the will to live is key.

The Most Common Questions Patients Have About Dialysis

The kidneys are vital organs in the human body. Their functions are those of secreting hormones, cleaning your blood, absorbing minerals and producing urine among others. They are absolutely necessary to maintain the body’s toxin levels at normal levels, they help regulate blood pressure and even stimulate the production of red blood cells.

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As you can probably guess, the kidneys have a lot of responsibility and are organs that work under constant stress. It is expected that when organs such as these stop working like they are supposed to, the consequences are dire, as the body loses its ability to regulate the toxins that are normally cleansed by the kidneys and you begin to feel sick.

Kidney disease is the term utilized to refer to the condition by which the functions of kidneys are reduced in their efficiency or in some cases completely impaired. In cases like this, there are but a few options available for a patient to stay alive. One would be a kidney transplant, and the other would be to receive dialysis treatment. Dialysis is a treatment by which advanced machinery is used to help cover the slack left by kidneys unable to perform their functions and thus remove excess toxins from the patient’s body.

Today in Joe Cosgrove’s blog, we want to talk about some of the most common questions and concerns raised by new patients to dialysis treatment, and by the family members who want to support them during their process.

What are the different types of dialysis?

There are three primary types of dialysis. Hemodialysis and hemofiltration work similarly because they are both concerned with the cleansing of the blood directly. Blood is removed and cleaned in a machine before being pumped back into the body. The difference between both of these methods is that one uses a dialyzer solution while the other uses pressure to separate substances through a permeable membrane.

The third type of dialysis is called peritoneal dialysis and is less efficient than the former methods. In peritoneal dialysis, the blood is not directly but indirectly cleansed by pumping dialyzer into the patient’s abdomen and then removing it after the waste material has transferred to the fluid. The process is repeated several times per session.

How does dialysis work?

Dialysis is a treatment that simulates the process done by the kidneys when they are healthy by removing excess toxins from the blood and keeps the body in balance. A machine is used to extract the blood of the patient (in the case of hemodialysis) and clean it before injecting it back in. Minor surgery is necessary to create a vascular access. Vascular access is a place where the needles and tubes can be easily connected every time the patient needs to undergo the procedure. An access can be created by joining an artery and a vein together into a blood vessel called a fistula or by placing a narrow plastic tube in a large vein near the chest or neck.

In peritoneal dialysis, the blood is actually cleaned inside the body. The doctor places a catheter in the patient’s abdomen so the peritoneal cavity can be filled with fluid and thus excess toxins from the blood can be extracted from blood vessels in the abdomen that come in contact with the dialyzer that is later removed.

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Is it possible to travel?

Traveling is absolutely possible, but it requires a bit more planning that you may be used to. Dialysis can be done by the patient him or herself while traveling with no real risk. There are also many centers around the country and even worldwide that can accommodate your needs while traveling and give you all the care you need. It is imperative to plan properly and to have everything planned well in advance so you can receive the treatment you need.

Does my diet have to change?

The food you eat will depend on many factors like your current health, the stage of your particular kidney disease and the recommendations of your doctor depending on their evaluation of your specific situation. Salt, in general, is to be avoided in large quantities; the same goes for foods that contain too much phosphorus. Anything that can affect your blood pressure has to be eaten in moderation, and it is recommended to eat fewer proteins than usual, especially if you eat lots of meats and animal products.

How often do I have to undergo the treatment?

The frequency of dialysis sessions you require depends mainly on the current state of your kidneys. Some patients with a more advanced condition may require more sessions than someone whose kidneys are still performing partially. Normally, hemodialysis takes places about 3 times a week while visiting the clinic and peritoneal dialysis is usually done at home, several times during the day. As we have mentioned before, one method is more effective than the other, and that is why it requires fewer sessions.