Dr. V. Narayanan Unni, Senior Lead Consultant, Nephrology
Posted on Monday, June 19, 2017
The main function of the kidneys is removal of waste products and excess water from the body and excrete them through urine. Hence, when the kidneys fail, waste products of metabolism and excess water accumulate in the body. Excess levels of the nitrogenous waste products in the blood leads to dysfunction of many other organs in human body.
A person who has lost over 85% of the function of his/her kidneys is diagnosed to have end stage kidney failure. At this stage of kidney disease, the person cannot lead a comfortable life with medications alone ; he/she would have to undergo the treatment modality known as dialysis.
The word “Dialysis” originates from a Greek word which means to “remove from”. It is essentially a treatment to get rid of harmful waste products from the body and thus purify blood. Patients with severe loss of kidney function (end stage kidney failure) need to undergo dialysis, so that the high levels of waste products in the blood come down to acceptable levels. There are two types of dialysis : Hemodialysis and peritoneal dialysis.
In hemodialysis an artificial kidney is used to remove the excess quantities of waste products from blood ; patient’s blood is passed through the dialyzer , blood is filtered (purified) and the purified blood is then returned back to the patient. The artificial kidney is called the Dialyzer , which is made of a particular type of polymer membrane with the ability to allow transfer of small molecules to pass from the patient’s blood. A machine known as the dialysis machine is used to monitor and deliver the correct dose of dialysis, thus ensuring patient safety during the process. This treatment needs to be done for four hours three times a week. The treatment has to done regularly without fail.
In peritoneal dialysis, the patient’s own peritoneal membrane (a thin membrane surrounding the intestines) is used to perform the dialysis. A plastic catheter is introduced in the abdominal cavity ; a solution known as peritoneal dialysis solution is passed into the abdominal cavity, kept inside for a few hours and then drained out. The peritoneal membrane does the function of an artificial kidney in hemodialysis. The patient and a relative can be taught to perform this type of dialysis, so that this treatment can be done at home. Peritoneal dialysis can be done manually or with the help of a machine (automated peritoneal dialysis).
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