Current DateSeptember 27, 2021

How does kidney dialysis work?

The kidneys normally have a filtering effect: they rid the body of waste products and excess fluid. If kidney function is reduced to less than 10%, it is necessary to artificially replace the functioning of the kidneys with dialysis.

Two forms of kidney dialysis

There are two forms of renal dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis

In hemodialysis, a vascular surgeon establishes a connection or fistula between a vein and an artery in the wrist or forearm. Through this compound, the blood is pumped to the hemodialysis machine (the artificial kidney). The machine purifies the blood, extracts the excess fluid, and adds any useful substances to the blood.

Then the blood is pumped back into the body. Since a lot of fluid is quickly extracted from the body, hemodialysis can provide a feeling of malaise and fatigue. In the longer term, damage to the heart and blood vessels is also possible.

This form of kidney dialysis should be done three times a week and takes four hours. Usually, the treatment takes place in the hospital, but nowadays there are also adapted devices for hemodialysis at home.

Peritoneal dialysis

In peritoneal dialysis, the peritoneum is used as a filter to remove waste products. The peritoneum lies like a pouch around your abdominal organs and contains a lot of small blood vessels. Through a catheter, a sterile fluid is inserted into the abdominal cavity that attracts waste products and excess fluid from the blood vessels. After a few hours, this drainage liquid, with the waste products in it, is removed and replaced with pure liquid. The fluid remains in the patient’s body for most of the day or night.

In peritoneal dialysis, the patient first learns to operate the equipment in the hospital, so that they can perform the dialysis themself at home. Every six weeks there is also a check-up in the hospital.

With chronic outpatient peritoneal dialysis, dialysis occurs four times a day for 30 minutes. Automatic peritoneal dialysis occurs at night when the patient sleeps and lasts from 8 to 10 hours. Peritoneal dialysis is usually not possible for more than a few years due to long-term changes in the peritoneum and complications such as peritonitis.

Precautions

Be alert for complications such as fever, abdominal pain, redness around the entrance to the catheter, fluid accumulation in the legs (edema) or other parts of the body. Contact your doctor immediately if you notice any of these symptoms.

Because your kidneys are not working properly, you should not drink too much. A good rule of thumb for the intake of fluid is: 800 ml + the volume that you have urinated that day. Excessive fluid loss or fluid accumulation can be detected by weighing yourself daily. A rapid weight change is a signal that something is wrong.

Strictly adhere to your prescribed diet and respect the salt restriction. Kidney patients should also limit the amount of phosphate they intake. Due to the poorly functioning kidneys, the phosphate balance in the body is no longer automatically regulated. You can find this nutrient in protein-rich products such as milk, cheese, meat and fish.

In addition, good oral and dental care is very important. If you have tartars removed, antibiotics are always given. Also check your blood pressure regularly and write down the measured values. Always measure it on the arm where there is no fistula.

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