Dialysis

Dialysis is a medical procedure used to remove waste products and excess fluid from the blood when the kidneys are not functioning properly. It mimics the natural filtration process of the kidneys, which are responsible for filtering blood and maintaining fluid and electrolyte balance.

Types of Dialysis:

1. Haemodialysis:

   • Process: Blood is drawn from the body, filtered through an artificial kidney (dialyzer) outside the body, and then returned to the bloodstream.
   • Dialyzer: The dialyzer has a semi-permeable membrane that allows waste products and excess fluids to pass through while retaining blood cells and proteins.
   • Frequency: Typically performed thrice a week, each session lasting about 3 to 5 hours.
   • Access: Blood access is usually achieved through a fistula (a surgically created connection between an artery and a vein), a graft, or a catheter.

2. Peritoneal Dialysis:

   • Process: Uses the peritoneal cavity (the space within the abdomen) as the filtering membrane. A special dialysis solution (dialysate) is introduced into the abdominal cavity through a catheter, where it absorbs waste products and excess fluids. The solution is then drained and replaced with fresh dialysate.
   • Types:
     • Continuous Ambulatory Peritoneal Dialysis (CAPD): Involves manual exchanges of dialysate throughout the day.
     • Automated Peritoneal Dialysis (APD): Uses a machine to perform multiple dialysate exchanges, usually at night.

Role of Dialysis in Medicine:

1. Kidney Failure Management:

   • Acute Kidney Injury: Dialysis temporarily manages kidney function until recovery or a decision is made for long-term treatment.
   • Chronic Kidney Disease: For patients with end-stage renal disease (ESRD), dialysis is a long-term solution to replace lost kidney function and maintain life.

2. Waste Removal:

   • Uremia Treatment: Dialysis helps remove waste products such as urea and creatinine that accumulate in the blood when kidneys cannot filter effectively, thus preventing complications like uremic syndrome.

3. Fluid and Electrolyte Balance:

   • Fluid Removal: Excess fluids that the kidneys would normally excrete are removed to prevent fluid overload, which can lead to symptoms like swelling, hypertension, and heart failure.
   • Electrolyte Regulation: Dialysis helps balance electrolytes (sodium, potassium, calcium) in the blood, which are crucial for proper cell function and overall health.

4. Acid-Base Balance:

   • Correcting Imbalances: Dialysis helps correct metabolic acidosis (a condition where the blood becomes too acidic) by removing excess hydrogen ions and restoring normal blood pH.

5. Quality of Life:

   • Symptom Management: Dialysis alleviates symptoms related to kidney failure, such as fatigue, itching, and nausea, improving the patient’s quality of life.

6. Bridge to Kidney Transplant:

   • Pre-transplant: For patients awaiting a kidney transplant, dialysis acts as a temporary measure to sustain life and health.
   • Post-transplant: In some cases, dialysis may be needed temporarily following a transplant until the new kidney becomes fully functional.

7. Research and Innovation:

   • Advancements: Ongoing research in dialysis technology aims to improve treatment efficiency, reduce complications, and enhance patient comfort, including innovations like wearable or portable dialysis devices.