Dialysis types, procedure advantage and disadvantage

dialysis

1. DIALYSIS TYPES, PROCEDURE ADVANTAGE AND DISADVANTAGE ENROLLMENT NO : 41 NAME: PATEL JAHANVI RAJESH KUMAR PharmD PB FIRST YEAR, SUBMITTED TO : PALAK PATEL.

2. DEFINATION OF DIALYSIS A method of removing toxic substances (impurities and wastes) from blood when kidneys are unable to do so. This techniques can be life saving in people with acute or chronic kidney failure. Types:- Hemodialysis Peritoneal dialysis

3. DIFFUSION:- Movement of solutes from an area of greater concentration to an area of lower concentration In renal failure urea, creatinine, uric acid and electrolytes moves from the blood to dialysate with net effect of lowering their concentration in the blood. But white blood cells and other contents within blood are too large to diffuse across the membrane.

4. OSMOSIS:- The movement of fluid from an area of lesser to an area of greater concentration of solutes. Glucose is added to the dialzing solution and creates an osmotic gradient across the membrane to remove excess fluid from the blood.

5. ULTRA FILTRATION: It is water moving under high pressure to an area of lower pressure. This process is much more efficient at water removal than osmosis. Ultrafiltration is accomplished by applying negative pressure or a suctioning force to the dialysis membrane.

6. This Photo by Unknown Author is licensed under CC BY-NC-ND

7. HEMODIALYSIS A hemodialysis process which requires a machine to transport the blood and dialyzing fluid on either side of a semipermeable membrane to effect the removal of toxic metabolizes and excess fluid or water. Life expectancy on dialysis can vary depending upon other medical conditions and how well you follow your treatment plan. Average life expectancy on dialysis is 5-10 years

8. PROCEDURE:- Blood coming from patient. Blood is drown by pump. Pressure is sensored . Blood pump flows. Pressure of blood flow. blood then flows to kidney where unwanted components are removed by diffusion excess fluid is removed by pressure. Blood is diffused against “dialysate” fluid which is made up of (acid + bicarbonate) mixed to correct strength with treated water. The blood then leaves the kidney, treated, and return to the dialyzer (in bottom). At the top of the dialyzer, display showing time left on treatment fluid to be removed and much more. Bag of saline to wash blood back at the end of treatment.

9. FUNCTION OF HEMODIALYSIS Cleanses the blood of accumulated waste products. Maintains or restores, Buffer system and electrolytes of body. Removes excessive fluids and byproducts of protein metabolism like urea, creatinine and uric acid. It helps to control blood pressure balance important minerals such as potassium, sodium, And calcium in your blood.

10. PERITONEAL DIALYSIS DEFINATION:- Peritoneal dialysis which contains the peritoneum in a person’s abdomen as the membrane through which fluid and dissolved substances are the exchanged with the blood.

11. PROCEDURE:- Preparing patient:- Baseline vital signs, weight, serum electrolyte levels are recorded. Patient is encouraged to empty bladder and bowel to reduce risk of puncturing internal organ. Preparing the equipment:- Determine the concentration are added, dialysate is set at body temperature to prevent patient discomfort and abdominal pain dilate the vessels of peritoneum to increase urea clearance solution that are cold cause pain and vasoconstriction and reduce clearance solution that are too hot burn the peritoneum. Assemble to fill tubing with prepared dialysate to reduce amount of air entering catheter and peritoneal cavity, which increase abdominal discomfort and interfere with instillation and drainage of fluid. Inserting catheter:- Peritoneal catheter is inserted in operating room to maintain surgical asepsis and minimize risk of contamination. Performing exchange:-(1 to 4 hours) It involves a series of exchange defines, Infusion od dialysate, dwell of dialysate, drainage of dialysate at the equilibrium time.

12. ADVANTAGE:-(hemodialysis and peritoneal dialysis) [COMMON] Easy to use without specified equipment. More independence and mobility of the client. May give better quality of life. Lower risk of hepatitis-C. May allow the better blood pressure and volume control with cardiovascular benefits. Essay to manage in home and community health care facility.

13. CONTINUE (HAEMODIALYSIS) PATIENT PERSPECTIVE: Dialysis procedure done by others. Social structure related to attending dialysis unit Regular medical review when attending dialysis.

14. Physician perspective: Familiar with hemodialysis; complications often regarded as part of treatment. Well-established pathways to start patient on hemodialysis so easy to organize. Very few medical contraindications so less need to assess patient for medical and psychosocial eligibility. Ease of achieving ‘adequate dialysis’.

15. ADVANTAGES : (PERITONEAL DIALYSIS) PATIENT PERSPECTIVE : Home based treatment so more patient independence . Fits in with social activities can be done by caregiver ( family or paid assistant). Fewer hospital visits does not require vascular access flexibility of treatment. Easier to travel for holidays or to visit family.

16. Physician perspective: Patient independence on home treatment. Avoids hemodynamic disturbance. Prolongation of residual renal function. Flexibility in dialysis

17. DISADVANTAGE(hemodialysis and peritoneal dialysis) [common] Needs to carried out everyday. Patients may not be able to set their own treatment schedule. May risk of infection /peritonitis. Requires permanent catheter, outside the body.

18. Hemodialysis dialysis (patient perspective Disadvantage):- Impact of therapy on quality of life. Can interfere with social and family life. Transport needs to be added into treatment time. Prolonged recovery time; many feel washed out for hours after dialysis session. Difficult to travel for holidays or to visit family. Vascular access can be difficult to establish and maintain and may require multiple procedures.

19. Peritoneal dialysis DISADVANTAGE (Patient perspective) Impact of therapy on quality of life Has to do procedure or have assistance Needs space to store dialysis supplies Treatment burden repetitive nature of peritoneal dialysis. Fear of infection and peritonitis.

20. Hemodialysis DISADVANTAGE (PHYSICIAN PERSPECTIVE) Risk of intradialytic hypotension . Vascular access may be difficult . Risk of infection with central venous access . Transport needs may add to cost . Loss of residual renal function.

21. Peritoneal Dialysis DISADVANTAGE (PHYSICIAN PERSPECTIVE) Often not familiar with peritoneal dialysis and only see patients with complications. Perception that older patients can not peritoneal dialysis so not offered. Risk of infection:- Risk of technique failure due to infection or inadequate clearance or ultrafiltration once anuric.