What is Dialysis? Dialysis is a medical treatment that removes waste products, toxins, and excess fluids from the blood when the kidneys are no longer able to function adequately. It helps maintain the balance of electrolytes, blood pressure, and body fluids. Dialysis is typically used for patients with chronic kidney disease (CKD) or acute kidney injury (AKI). Types of Dialysis 1. Hemodialysis (HD) Blood is filtered outside the body using a machine and dialyzer (artificial kidney). Done in a hospital, dialysis center, or at home. Requires vascular access (e.g., arteriovenous fistula, graft, or catheter). 2. Peritoneal Dialysis (PD) The lining of the abdominal cavity (peritoneum) acts as a natural filter. A sterile dialysis solution is infused into the abdominal cavity through a catheter. Types of PD: Continuous Ambulatory Peritoneal Dialysis (CAPD): Manual fluid exchanges throughout the day. Automated Peritoneal Dialysis (APD): Uses a machine at night while the patient sleeps. 3. Continuous Renal Replacement Therapy (CRRT) Used primarily in critically ill patients in intensive care units. Provides slow and continuous dialysis over 24 hours. Indications of Dialysis Dialysis is indicated in: 1. Chronic Kidney Disease (CKD) – End-Stage Renal Disease (ESRD) 2. Acute Kidney Injury (AKI) – Severe and life-threatening cases. 3. Electrolyte Imbalances – Refractory hyperkalemia or severe acidosis. 4. Fluid Overload – Unresponsive to diuretics. 5. Uremic Symptoms – Such as encephalopathy, pericarditis, or severe nausea. 6. Toxin Removal – Certain drug overdoses or poisonings (e.g., methanol, ethylene glycol). Procedure of Dialysis Hemodialysis Procedure 1. Vascular Access: Ensure functional AV fistula, graft, or catheter. 2. Preparation: Patient is connected to the dialysis machine via needles or catheter. 3. Dialysis: Blood is drawn, filtered through a dialyzer, and returned to the body. 4. Monitoring: Blood pressure, heart rate, and electrolytes are continuously monitored. 5. Duration: Typically 3–4 hours, 3 times a week. Peritoneal Dialysis Procedure 1. Catheter Placement: A permanent catheter is surgically placed into the abdominal cavity. 2. Filling: Dialysis solution is introduced into the peritoneal cavity. 3. Dwell Time: Solution remains for several hours, allowing waste exchange. 4. Draining: Fluid is drained and replaced with fresh solution. 5. Frequency: Varies depending on type (CAPD or APD). Complications of Dialysis Hemodialysis Complications 1. Hypotension – Common during or after sessions. 2. Infections – At vascular access sites. 3. Vascular Access Issues – Thrombosis, stenosis, or aneurysm. 4. Electrolyte Imbalance – Rapid shifts causing cramps or arrhythmias. 5. Dialysis Disequilibrium Syndrome – Neurological symptoms from rapid toxin removal. 6. Bleeding Risks – Due to heparin use. Peritoneal Dialysis Complications 1. Peritonitis – Infection of the peritoneum. 2. Catheter Infections – At the insertion site. 3. Hernias – Due to increased intra-abdominal pressure. 4. Protein Loss – Leads to malnutrition. 5. Dialysate Leaks – Fluid leakage around the catheter site. - @medical.nursing.e