Wednesday, October 19, 2011

dialysis

Disclaimer: This is by no means an exhaustive explanation on the various types of dialysis. What I have tried is to describe the various options of dialysis as simply as possible. If you are interested in further information, you could leave a comment for me and I shall be happy to share with you whatever I know. Everyday I learn more about chronic renal failure. However, I am not a doctor.. For medical opinions, please consult a nephrologist.



Haemodialysis -
If your doctor recommends this type of dialysis for you then you undergo an operation that unites a nerve and an artery from your body. This unified nerve-artery is called a 'fistula' and, usually, it is crafted on the left arm.  Depending on what your doctor prescribes, you go to hospital 2 or 3 times a week. You are hooked up to a machine from your fistula. The blood from your body is made to circulate through the machine for about 4 hours. The machine performs the function of your kidneys - it purifies your blood. Your blood circulates through the machine, is purified and  then directed back into your body.  You a kept under observation for another 30 minutes - 1 hour.
Pros
- In case of emergency, this type of dialysis can be performed even without the surgery to create the fistula. 
- Haemodialysis is conducted in the hospital, under constant medical supervision. It is different from peritoneal dialysis, which is done by the patient's family members, at home.
Cons
- Be prepared to devote a good part of your day in the hospital - about 1 hour of preparation, 4 hours of dialysis, and another hour of being under observation - a total of 6 hours. Travel time to and from the hospital is extra.
- There is a risk of heart attack as it puts additional pressure on the heart.

Peritoneal Dialysis / CAPD (Continuous Ambulatory Peritoneal Dialysis) -  You have a surgery to insert a catheter inside your peritoneal cavity, located in the abdomen. A small portion of the catheter will jut out of your stomach for the rest of your life. It takes about 2 weeks to heal from the surgery before the catheter is ready to be used. In the meantime, you may need to undergo haemodialysis. As peritoneal dialysis is done at home, your family / housemates will have to be trained to perform it. Training usually takes about 3 - 5 days. When you have recovered from the surgery, you can begin peritoneal dialysis at home. The part of the catheter jutting out of your body is connected to 2 bags. Dialysate fluid from the first bag is sent in via the catheter, it purifies the blood and waste material flows out into the second bag. The procedure takes 30 minutes. It needs to be done daily, at 8 hour intervals. So basically, you would need to have it 3 times a day.
Pros 
- You don't have to spend entire days in the hospital
- Since it takes only 30 minutes and only needs to be done at 8 hour intervals, you could go out to work or have time for other activities.
- If you are not confident, you can hire a dialysis technician to visit your home and conduct CAPD for you
Cons - It is done at home, and not in the hospital where you would have medical assistance within easy reach
- There is a risk of infection - peritonitis
- You have to work very hard to maintain the highest standards of hygiene in your home

APD (Automated Peritoneal Dialysis) - You undergo the same catheter insertion surgery as you would for CAPD / Peritoneal dialysis. Every night, you connect the catheter to an APD machine that performs dialysis for you while you sleep. 
Pros 
You are absolutely free to go about your day.
Cons
You may not be rich enough to afford this hassle free, patient friendly technology.


 

No comments: