Dialysis

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Dialysis refers to an artificial means of removal of the waste substances from the body using a specialised membrane.

There are two forms namely hemodialysis or blood dialysis, and peritoneal dialysis.

In hemodialysis, a mechanised blood pump is needed to draw blood from the patient. The blood is circulated into the machine and passes along a specialized membrane (a dialyser) which in essence functions as an artificial kidney. Waste substances from the blood move across the membrane into the solution called a dialysate by a physical process called diffusion. The cleaned blood exits the dialyser and is returned back to the patient.

In hemodialysis, the patient needs to have a surgically created vein that is large enough and with a high enough blood flow to allow efficient and adequate dialysis. The surgeon will create this specialised vein called an arterio-venous fistula or access by connecting 2 blood vessels together.

In peritoneal dialysis, the lining of the abdomen has a membrane that can similarly function like a dialyser membrane. This lining is used as the artificial kidney in peritoneal dialysis. In peritoneal dialysis, a permanent tube (called a tenchkoff catheter) is placed under sterile conditions into the abdominal cavity. Specialized fluid called a dialysate is placed into the abdomen. The waste substances present in the blood flowing through the blood vessels of the abdomen itself move across this membrane into the dialysate. The dialysate is then removed, discarded, and a fresh bag of dialysate placed back into the abdomen to continue dialysis.

Which one to choose? Every patient who has kidney failure and facing the prospect of dialysis will usually ask the following questions. "Which is the best form of dialysis?" and " Which one is the most suitable for me?" The answer is not simple. In fact one form of dialysis is not necessarily superior to another.The type of treatment that the patient chooses must eventually be acceptable to themselves, their families and caregivers. Sometimes mode of dialysis is chosen because of varying lifestyles, ease of access to a dialysis centre, family support, and often because of medical issues.

Every patient who has kidney failure and facing the prospect of dialysis will usually ask the following questions. "Which is the best form of dialysis?" and " Which one is the most suitable for me?"

The answer is not simple.

In fact one form of dialysis is not necessarily superior to another. The type of treatment that the patient chooses must eventually be acceptable to themselves, their families and caregivers. Sometimes mode of dialysis is chosen because of varying lifestyles, ease of access to a dialysis centre, family support, and often because of medical issues.