The main function of dialysis is to help individuals with impaired renal function filter toxins their blood. When your kidneys are damaged, they are no longer able to remove wastes and excess fluid from your bloodstream efficiently. Wastes such as nitrogen and creatinine build up in the bloodstream.

During peritoneal dialysis, a cleansing fluid passes through a tube (catheter) to a section of your abdomen during peritoneal dialysis. The lining of the abdomen (peritoneum) acts as a filter and removes waste products from your blood. After a certain period of time, the fluid with the filtered waste products runs out of your stomach and is discarded. These treatments can be done at home, at work or while traveling. But peritoneal dialysis isn’t an option for everyone with kidney failure- you need manual dexterity and the ability to care for yourself at home, or you need a reliable caregiver.

There are numerous different types of peritoneal dialysis. The main ones are:

  • Continuous ambulatory peritoneal dialysis (CAPD). In CAPD, your abdomen is filled and drained multiple times each day. This method doesn’t require a machine and must be performed while awake.
  • Continuous cycling peritoneal dialysis (CCPD). CCPD uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep.
  • Intermittent peritoneal dialysis (IPD). This treatment is usually performed in the hospital, though it may be performed at home. It uses the same machine as CCPD, but the process takes longer.

On the other hand, an artificial kidney (hemodialyzer) is used in hemodialysis (the most common type of dialysis) to extract waste and extra fluid from the body. The blood is drained from the liver, and the artificial kidney removes it. Then the purified blood is transferred to the bloodstream using a dialysis machine.

To get the blood to flow to the artificial kidney, your doctor will perform surgery to create an entrance point (vascular access) into your blood vessels. The three types of entrance points are:

– Arteriovenous (AV) fistula. This type connects an artery and a vein. It’s the preferred option.

– AV graft.This type is a looped tube.

Vascular access catheter. This may be inserted into the large vein in your neck.

Continuous renal replacement therapy (CRRT) is used primarily in the intensive care unit for people with acute kidney failure. It’s also known as hemofiltration. A machine passes the blood through tubing. A filter then removes waste products and water. The blood is returned to the body, along with replacement fluid. This procedure is performed 12 to 24 hours a day, generally every day.

Risks associated with hemodialysis

  • low blood pressure
  • anemia, or not having enough red blood cells
  • muscle cramping
  • difficulty sleeping
  • itching
  • high blood potassium levels
  • pericarditis, an inflammation of the membrane around the heart
  • sepsis
  • bacteremia, or a bloodstream infection
  • irregular heartbeat
  • sudden cardiac death, the leading cause of death in people undergoing dialysis

Risks associated with peritoneal dialysis

Peritoneal dialysis is associated with an increased risk in the abdominal cavity for infections at or around the catheter site. A person can experience peritonitis, for example, after catheter implantation. Peritonitis is an infection of the membrane lining the abdominal wall. Other risks include:

  • abdominal muscle weakening
  • high blood sugar due to the dextrose in the dialysate
  • weight gain
  • hernia
  • fever
  • stomach pain

Risks associated with CRRT

The risks associated with CRRT include:

  • infection
  • hypothermia
  • low blood pressure
  • electrolyte disturbances
  • bleeding
  • delayed renal recovery
  • weakening of bones
  • anaphylaxis

Image by Saengsuriya Kanhajorn from Shutterstock

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