The goal of dialysis is to mimic the functions of the kidney as much as possible, including excreting nitrogenous waste products, Maintaining normal salt/mineral concentrations, and maintaining normal fluid content in the body.
There are two types of dialysis that can be done, one is called hemodialysis and the other us peritoneal dialysis.
In this method, blood from the individuals arm is pumped through a dialyser and the diasylate balances the and filters the blood to normal. An adult of average size usually receives 4-5 hours treatment three times per week.
Complications of Hemodialysis
- Fall in blood pressure during dialysis
- Severe allergic reactions
- Hard water syndrome
- Hemolytic reactions
- Air bubble entrapment
- Dis-equilibrium syndrome : Rapid correction of uremia – causing nausea, vomiting, restlessness, headache, hypertension, seizures and coma in severe cases.
- Dialysis dementia
- Hepatitis B and C
- Complications of heparin
Peritoneal dialysis works by using the peritoneal membranes in the abdomen as a filter instead of using the dialysis machine. A tube is inserted into the abdomen and diasylate solution is made to run into the peritoneal cavity under gravity. waste products are passed into the diasylate and the fluid is chaged regularly to repeat the process.
- Can be performed for people in which hemodyalisis is not suitable
- Phosphates are cleared better so less dietary restrictions
- Decreased symptomatic swings observed in hemodyalisis
- Greater patient autonomy
- Peritonitis (infection of the peritoneum)
- Less efficient than hemodyalisis
This is a step that must be in consideration in all people with end stage kidney failure, the doner can be from a living close relative or a cadaveric ( patients with brain death)
Some complications that may arise however are…
- Increased risk of infection due to immune system suppression drugs
- Increased risk of skin cancer of lymphoma
- Recurrence of the disease that caused renal failure
- Side effects of the immunosuppresant drugs like ;
- Corticosteroids: weight gain, stretch marks, diabetes, osteoporosis, high blood pressure.
- Cyclosporin: Kidney toxicity, rash, tremor, increased hairiness, gingival growth, diabetes and high blood pressure
- Azathioprine : bone marrow suppression and liver toxicity
- Tacrolimus: brain and liver toxicity.
About 80% of transplants are successful for 5-10 years and 60% after 10-30 years.