Dialysis : Haemodialysis and Peritoneal dialysis

Process used to filter the blood in patients with condition of renal failure

1. DIALYSIS -BY ROHAN BORALKAR

2. OUTLINE Introduction PRINCIPLE TYPES (HEMOLYTIC ; PERITONEAL) PROBLEMS WITH DIALYSIS

3. INTRODUCTION A process of purifying the blood of a person whose kidneys are not working normally. This process is used when the kidneys are unable to filter the blood properly. This is referred to as renal replacement therapy. The first successful dialysis was performed in 1943.

4. CONT’D… Dialysis may need to be initiated when there is a sudden rapid loss of kidney function, known as acute kidney injury. when a gradual decline in kidney function, chronic kidney disease, reach stage 5. Dialysis is used as a temporary measure in either acute kidney injury or in those awaiting kidney transplant and as a permanent measure in those for whom a transplant is not indicated or not possible .

5. PRINCIPLE OF DIALYSIS Dialysis works on the principles of the diffusion of solutes and ultrafiltration of fluid across a semi-permeable membrane. Blood flows by one side of a semi-permeable membrane, and a dialysate, or special dialysis fluid, flows by the opposite side. Smaller solutes and fluid pass through the membrane, but the membrane blocks the passage of larger substances (for example, red blood cells and large proteins). This replicates the filtering process that takes place in the kidneys when the blood enters the kidneys and the larger substances are separated from the smaller ones in the  glomerulus

6. TYPES OF DIALYSIS There are two types of dialysis…. Hemodialysis Peritoneal dialysis

7. HEMODIALYSIS This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. The principle of hemodialysis is the same as other methods of dialysis; it involves diffusion of solutes across a semipermeable membrane.

8. PROCEDURE Before few weeks or months before the dialysis , to get the access of patient’s vascular system to get blood out and to provide filtered blood again some surgical methods are used. Fistula Graft By using these techniques we can easily get access to vascular system. After the complete healing , the physician moves towards dialysis Now the artery and vein is connected to a machine called dialyzer .

9. ARTERIOVENOUS FISTULA A surgical procedure in which the artery and vein are joined to get a larger vessel called fistula. After the joining it takes 4-5 weeks to recover properly.

10. ARTERIOVENOUS GRAFT An incision is made to site and artery and vein are connected through a tube known as graft. This tube will give access to both vein and artery.

11. CONT'D As we have connected two separate tubes for each artery and vein so both tubes are connected to dialyzer . The blood enters the machine and passes through the dialyzer . The blood and dialysate moves in opp. Directions in the dialyzer. Due to the mechanism of diffusion and ultra filtration , the waste products , electrolytes are separated and moved towards the disposal bag. Now , as the blood is filtered it is passed through the another tube connected to the machine and transferred to the body.

12. PERITONEAL DIALYSIS Peritoneal dialysis is a type of dialysis which uses the peritoneum in a person’s abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure. During peritoneal dialysis, a cleansing fluid flows through a tube (catheter) into part of your abdomen. The lining of your abdomen (peritoneum) acts as a filter and removes waste products from your blood. After a set period of time, the fluid with the filtered waste products flows out of your abdomen and is discarded.

13. PROCEDURE In this type of dialysis a tube known as catheter is inserted into the abdomen of patient. With the help of catheter the dialysate is passed into the abdomen. Now by using the peritoneal membrane further procedure is carried out. Here , peritoneal membrane act as semipermeable membrane for filtration . Further filtration takes place by the process of diffusion and ultra filtration.

14. PROBLEMS WITH DIALYSIS Hypotension Dehydration Muscle Cramps Sleep problems Anemia Bone Disease High Blood pressure

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