From the Guidelines
Dialysis bypasses the kidney by artificially performing the kidney's blood filtering functions outside the body, relying on diffusion and ultrafiltration to remove waste products and excess fluid. In hemodialysis, blood is removed from the body through a vascular access point, such as an arteriovenous fistula (AVF) or arteriovenous graft (AVG), and pumped through a dialyzer (artificial kidney) 1. The dialyzer contains a semipermeable membrane that allows waste products and excess fluid to diffuse into dialysate fluid, which is then discarded. The cleaned blood is then returned to the body. This process is crucial for patients with end-stage renal disease, as it helps to maintain electrolyte balance, remove waste products like urea and creatinine, and eliminate excess fluid that the kidneys would normally process 1.
Key Components of Dialysis
- Vascular access: a critical component of dialysis, which can be achieved through an AVF, AVG, or central venous catheter (CVC) 1
- Dialyzer: an artificial kidney that filters waste products and excess fluid from the blood 1
- Dialysate: a fluid that helps to remove waste products and excess fluid from the blood 1
Types of Dialysis
- Hemodialysis: uses a dialyzer to filter waste products and excess fluid from the blood 1
- Peritoneal dialysis: uses the patient's peritoneal membrane as a filter, with dialysate fluid introduced into the abdominal cavity through a catheter 1
Importance of Dialysis
- Helps to maintain electrolyte balance and remove waste products like urea and creatinine 1
- Eliminates excess fluid that the kidneys would normally process 1
- Improves quality of life for patients with end-stage renal disease 1
From the Research
Dialysis Process
- Dialysis is a treatment that filters and purifies the blood using a machine, bypassing the kidney's normal function 2
- The process involves the use of a dialysis membrane, which removes accumulated uremic toxins, excess ions, and water from the patient's blood and supplies necessary ions from the dialysate 2
Hemodialysis Access
- Hemodialysis access is typically achieved through a catheter, arteriovenous fistula, or arteriovenous graft 3
- The choice of access type can affect the patient's outcome, with arteriovenous fistulas generally considered the best option 3
Factors Affecting Dialysis Outcome
- Several factors can affect the outcome of dialysis, including the patient's hemoglobin level, age, and presence of comorbidities such as diabetes and hypertension 4
- Correction of anemia and control of blood pressure can improve the patient's response to dialysis and reduce the risk of complications 4
Dialysis Membranes
- Dialysis membranes are used to filter the patient's blood and remove waste products 2
- The type and characteristics of the dialysis membrane can affect the efficiency and safety of the dialysis process 2