What Is Dialysis?
Dialysis is a treatment modality offered to patients who have kidney failure. When you have kidney failure, your kidneys do not filter blood properly. As a result, wastes and toxins build up in the bloodstream, so By removing waste products and excess fluid from your blood by dialysis, it will replicate the work of your kidneys.
Who Needs Dialysis?
Dialysis is advised for people who have kidney failure or end-stage renal disease (ESRD). Kidney disease can be caused by injuries or conditions such as high blood pressure, diabetes, and lupus.
Kidney failure can be chronic or acute, resulting from a severe illness or injury. Usually, acute kidney failure is reversible if treated appropriately, but chronic kidney failure is irreversible. Hence the need for dialysis is temporary in acute kidney failure, and the need for dialysis will be permanent in chronic kidney failure.
Types Of Dialysis?
There are two types of dialysis :
- Peritoneal dialysis
Many prospective patients believe that dialysis will be done in a centre at least three times per week for an average of four hours is the only option for end-stage renal disease (ESRD). This is not true, and there are other options available, such as peritoneal dialysis (PD), home haemodialysis treatment, and Kidney transplants.
What Is Peritoneal Dialysis?
Peritoneal Dialysis (PD) is a treatment that uses your peritoneum, a membrane lining your abdominal cavity, as a filter to remove wastes from your body. This type of dialysis requires the assistance of a care provider.
Your peritoneum performs a job similar to the dialyzer in a dialysis machine during treatment or that of your kidneys every day. Waste products and excess fluid in the blood pass through the peritoneal membrane and combine with dialysate (dialysis fluid) in the abdominal cavity, which is then drained along with the waste product diffused from the blood. The peritoneum separates your blood from the dialysis fluid and allows this diffusion process to take place. An exchange occurs whenever fluid is added to the abdomen. Thus extra fluid and wastes are drained along with the fluid.
When your kidneys are not working well, wastes and extra fluid can build up in your blood and make you sick.
This can cause:
- Trouble sleeping
- Poor appetite
- Loss of energy
- Dry, itchy skin
- Weight loss
- Irregular menstrual periods
- Muscle cramping, especially at night
- Anaemia (low blood count)
- Difficulty in breathing
Types Of Peritoneal Dialysis
There are two ways to perform peritoneal dialysis, they are :
- Continuous-Cycler Assisted Peritoneal Dialysis (CCPD)
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
Continuous-Cycler Assisted Peritoneal Dialysis (CCPD):
Continuous cycling peritoneal dialysis (CCPD) is a method of performing peritoneal dialysis exchanges while sleeping by using a cycler machine. Each night, three to five exchanges are performed. Their peritoneal dialysis treatment fluid is drained into drain bags and that you would empty in the morning. This program enables you to free up your daytime hours. And every night session lasts between eight and ten hours. And there are various modified techniques to this method which a nephrologist will advise as per the clinical need.
Continuous Ambulatory Peritoneal Dialysis (CAPD):
Continuous ambulatory peritoneal dialysis (CAPD) is a method of performing peritoneal dialysis exchanges that utilises gravity to drain and fill your peritoneal membrane with solutions. Usually, three to four exchanges per day are advised. The exchanges are done manually by a patient in a clean environment, which takes about 30 minutes to complete. And the patient is allowed to roam or travel after the peritoneal fluid exchange.
What Is Dialysate?
Dialysate is a liquid with sugar that pulls out fluid and waste from your blood. It works on the principle of diffusion and osmosis. When you exchange, the dialysate holds the waste and fluid and removes them from your body.
How Does The Catheter Get Into the Belly?
Before you start PD, doctors will perform minor surgery to insert the catheter into your belly. The end of the catheter will come through your skin, either on your belly or chest. And the catheter is inserted either using a laparoscope or a percutaneous method.
What will my dialysis prescription be based on?
Your doctor will base your prescription on:
- Your size
- Your remaining kidney function
- Your nutritional health
- Your general health
- Your peritoneal equilibration test (PET)
Catheter Placement and Care:
A tube or catheter is inserted into the abdominal muscles. One end is inserted into the peritoneal cavity. The peritoneal space is the empty space that surrounds the organs of the abdomen.
The other end of the tube extends about 6 inches from the abdomen. To protect the catheter site, promote healing, and prevent infection, a large dressing will be placed over it. The dressing will be changed about 5 days after surgery.
The catheter is not used for two weeks following placement to allow the area to heal. And If you require dialysis during this time, you will receive haemodialysis.
How Does Peritoneal Dialysis (PD) Work?
Peritoneal dialysis is carried out through a dialysis catheter placed in the abdomen, where you exchange the old solution for a new solution.An exchange has 3 steps: STEP 1: Drain
The PD catheter is connected to a drain bag, and the used and saturated solution inside the abdomen is drained. This solution contains waste as well as excess fluid.STEP 2: Fill
After the old solution has been completely removed from the abdomen, a new dialysis solution is poured in through the catheter to fill the peritoneal cavity, which is located in the abdomen.STEP 3: Dwell
The dialysis tubing and bags are removed once the new solution has been placed. You can do your normal activities while wearing only a short tubing set covered by a sterile cap. During this time, the dialysis solution remains in the peritoneal cavity. This is the time when dialysis takes place, and the solution collects waste and excess fluid from your body.
Benefits Of Peritoneal Dialysis
- There are no needles or pricks involved in this type of treatment.
- Diet and fluid intake are less restricted.
- You have more control and greater flexibility about when and where you dialyze.
- You can do therapy while sleeping (APD).
- You can dialyze in the comfort of your home independently or with the help of a loved one.
- You can take a more active role in your treatment which has been proven to yield better outcomes.
- Health benefits include more energy and better blood pressure control.
- Portable therapy allows for ease of travel.
- All home dialysis patients can access a home dialysis nurse 24 hours a day if assistance is needed. This includes access to a technical support team for equipment issues.
Complications of peritoneal dialysis (PD)
The most common complication for peritoneal dialysis is Peritonitis, other complications are:
- Fluid Imbalance
- High blood sugar
- Joint Disease
- Vascular and extra-articular calcification
- Weight Gain
What is peritonitis?
One thing you must be very careful about in PD is peritonitis, an infection of the peritoneum (the lining of the belly). Peritonitis happens when germs get into the peritoneal cavity through the catheter. It is treatable with antibiotics, but it's important to get it treated promptly.
The main signs of peritonitis are:
- A cloudy dialysis bag when you are
- Draining out the used fluid
- Unusual stomach pain, either mild or severe
- Fever or chills
If you notice any of these signs, call your nephrologist or dialysis centre near you immediately. Getting dialysis treatment for peritonitis is very important. If you do not get prompt kidney dialysis treatment, the infection can worsen, and you may have to go to the hospital. In addition, the infection may scar your peritoneal membrane, making PD less effective. In extreme cases, you may have to change to haemodialysis treatment.
In DR Pranith Ram's Renal Care Center, Our team have expertise in treating advanced kidney diseases and conditions and plays a vital role with the patient in ensuring their total well-being and providing the best available options depending on the situation. Patient diagnosis and treatments are of the top quality kidney dialysis cost in Hyderabad, and they always tend to ease up any patient, irrespective of the complexity of their position, to provide the best possible kidney dialysis Hemodialysis & peritoneal dialysis treatment in Hyderabad.