kidney and urinary tract disorders
Dialysis
Introduction
Dialysis is an artificial process for removing waste products and excess fluids from the body, a process that is needed when the kidneys are not functioning properly. There are a number of reasons why people may need dialysis, but the inability of the kidneys to adequately filter waste products from the blood (kidney failure) is the most common. Kidney function may decline quickly (called Acute Kidney Injury or acute kidney failure), or the kidneys may slowly lose their ability to filter waste products (called In people with kidney failure, many doctors recommend dialysis when blood tests show that the kidneys can no longer filter waste products adequately and the accumulating waste products cause problems. For acute kidney injury, doctors continue dialysis until the person’s blood test results indicate that adequate kidney function has been restored. For people with chronic kidney disease, dialysis may be used as long-term therapy or as a temporary measure until the person can receive a Kidney Transplantation . Short-term or urgent dialysis can also be used to remove fluids, certain drugs, or poisons from the body. Making the decision to begin long-term dialysis is not easy because it entails a major change in lifestyle, including a dependency on machines to maintain life. However, for most people, a successful dialysis program results in an acceptable quality of life. Most people undergoing dialysis are able to eat a tolerable diet and have normal blood pressure. Dialysisusually requires the effort of a team of people: A doctor establishes a dialysis prescription, manages complications, and provides the medical care. A nurse monitors the person’s general well-being, educates the person about dialysis and what needs to be done to maintain the best possible health, oversees the dialysis procedure, administers dialysis-related drugs, and supervises the dialysis technicians. Often, a social worker assesses mental health, arranges transportation, arranges for dialysis in other locations if the person is traveling, and arranges home assistance when needed. A dietitian recommends an appropriate diet and monitors the person’s response to dietary changes. A transplant surgeon is also part of the dialysis team when dialysis is intended to be used temporarily until a kidney can be transplanted. For Hemodialysis , A technician assists in getting the procedure started and monitors the dialysis machine during the dialysis. Doctors such as a vascular surgeon and often an interventional radiologist prepare the blood vessels so that blood can be easily withdrawn from the body and cycled through the dialysis machine. Doctors decide to place a person on dialysis when kidney failure is causing certain conditions: Abnormal brain function (uremic encephalopathy) Certain other severe symptoms, such as loss of appetite or vomiting and weight loss Inflammation of the sac around the heart ( Overview of Pericardial Disease ) A high level of acid in the blood ( Acidosis ) that does not decrease despite other treatments Heart Failure (HF) None Total body fluid overload Fluid overload in the lungs (pulmonary edema) that does not respond to other treatments A very high level of potassium in the blood ( Hyperkalemia (High Level of Potassium in the Blood) ) A high level of calcium in the blood ( Hypercalcemia (High Level of Calcium in the Blood) ) Greatly reduced kidney function Occasionally, another technique (such as hemofiltration or hemoperfusion) is used to temporarily filter the blood and accomplish what dialysis would. These techniques are most often used if dialysis cannot be done, to remove the poisons from the blood, or to remove large amounts of fluid in some people who have acute kidney injury. Occasionally, techniques other than dialysis are used to filter the blood. Hemofiltrationis often done as a continuous procedure in people who are seriously ill and in an intensive care unit. This procedure allows doctors to filter large amounts of blood. Hemoperfusionis most often used in treating poisoning. The person's blood flows over a filter that contains charcoal or some other material that absorbs the poison. 