The kidneys excrete the waste
products of the body. In renal (kidney) failure, the body is
unable to rid itself of all the waste. Dialysis is a
mechanical way to clean the blood of wastes and to regulate
the body's fluids and chemicals.
Why is it done?
Kidney failure leads to an
accumulation of waste products in the blood known as uraemia.
Untreated kidney failure may lead to death. Dialysis is used
in kidney failure and may be lifesaving. Dialysis is started
when the working of kidneys is reduced to less than 10%
capacity. Some people need dialysis temporarily, while
others may need it life-long.
How is dialysis done?
Dialysis can be done by two
methods - haemodialysis and peritoneal dialysis.
Haemodialysis is the most commonly used method of dialysis.
The blood is filtered through a dialysis machine that
removes the body wastes and extra fluid. A plastic tube or
catheter is inserted into a large vein in the neck or upper
chest. Alternatively, a permanent connection or shunt is
installed between an artery and a vein, usually in the
forearm. The dialysis machine is attached to the catheter or
shunt. Regular haemodialysis is done about thrice weekly,
usually in special dialysis clinics by trained staff. The
dialysis procedure is painless and takes 2 to 3 hours per
session.
Peritoneal dialysis uses the lining of the abdominal cavity
as a filter to clean the blood. Once a day, a special fluid
is put in the abdomen through an opening or port made
surgically. The lining of the abdominal cavity allows fluid,
wastes, and electrolytes to pass from the blood to the fluid
in the cavity. The fluid is left inside for about 2 hours
and then drained out through the port. The body wastes are
removed along with the fluid. Peritoneal dialysis can be
done at home with special training. The latter is called
CAPD (Continuous Ambulatory Peritoneal Dialysis).
What are the alternatives?
Dialysis is the initial
treatment in kidney failure. In acute kidney failure,
dialysis is done until the cause of the kidney problem is
corrected. In chronic kidney failure, nutritional therapy is
also needed along with dialysis. People with renal failure
can survive for years on dialysis. A kidney transplant is
the definitive treatment in selected patients. A kidney from
a related or unrelated donor or a brain-dead person is used
to provide a permanent cure to the kidney problem.
Dialysis Machine
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