Hemodialysis and peritoneal dialysis have been done since the mid 1940’s. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.

What is Dialysis?

Dialysis is one way of replacing the critical function of the kidneys, or renal replacement therapy, thereby sustaining life. Dialysis removes waste, salt and extra water to prevent them from building up in the body; keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate and helps to control blood pressure

Who Needs Dialysis?

People whose overall kidney function is so poor as to thrEaten adequate health and survival are said to have end-stage renal disease (ESRD), and need renal replacement therapy in the forms of dialysis or kidney transplantation. When a kidney transplant is not available or not feasible, dialysis can mimic the critical functions of the kidneys and sustain life. Today, about 200,000 people in the United States are on dialysis.

What do the Kidneys do?

Understanding the basic functions of the kidney is helpful in understanding dialysis. The kidneys contain filtering units called nephrons — about one million of them. The nephrons clean, or filter the blood of waste products that are produced by the body in its normal functioning. The amount of fluid, salts, and body chemicals circulating in the blood is also regulated by the kidneys. This filtering and regulating takes place 24 hours a day, which is why urine is produced around the clock. The kidneys also produce hormones essential to blood pressure control, bone health, and blood cell production.

When the kidneys fail, a person develops a condition known as uremia. This is the accumulation of waste products and excess fluid in the blood. Common blood tests that detect and measure this include the BUN (B-U-N or blood urea nitrogen) and creatinine. Symptoms of uremia are lack of energy, difficulties in mental concentration and poor appetite. In more advanced stages there are nausea, vomiting, difficulty breathing, aggravated high blood pressure, and very little urine production.

Dialysis replaces about 10 to 15 percent of the kidney’s filtering capacity. This has a significant effect on decreasing the symptoms of uremia and dramatically improving the quality of life of a patient.

Two Types of Dialysis

There are two types of dialysis: hemodialysis and peritoneal dialysis, both of which are available at Renal Specialists. They are:

Hemodialysis:

In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.

However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.

Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.

Most hemodialysis is performed at a dialysis center, specialized centers staffed by nurses and dialysis teclmicians with thorough training in the process. Some patients receive hemodialysjs at home. This requires intensive training and the assistance of a designated care giver.

Peritoneal dialysis

With this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate There are two major kinds of peritoneal dialysis.

Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two quarts) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity. you can go about your usual activities at work, at school or at home.

Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a special machine called a cYcler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges are done throughout the night while you sleep.

Can dialysis help cure the kidney disease?

No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments unless you are able to get a kidney transplant.