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Dialysis is a crucial medical procedure that mimics the function of the kidneys, effectively cleansing the blood of excess waste products and water. This treatment is primarily utilized for individuals with chronic renal failure, a condition characterized by the progressive and irreversible loss of kidney function. While a kidney transplant is the ideal solution, it is not always feasible. In such scenarios, regular dialysis is the only lifeline to sustain the patient.
Our kidneys work tirelessly each day to filter our blood, eliminating waste products and excess water and ions, which collectively form urine. They also regulate the concentration of ions and other solutes like glucose and amino acids in the blood. However, when the functional units of the kidney, known as nephrons, are damaged, these processes can be compromised. This can lead to the dangerous accumulation of waste products in the blood, which can be fatal without treatment.
Dialysis is a treatment that compensates for the diminished efficiency of certain kidney functions impaired by disease. It aids in the removal of toxic substances, maintains electrolyte and acid-base balance, and eliminates excess fluids.
The loss of kidney function can be a common outcome of a multitude of pathologies, both directly and indirectly affecting the kidneys. When the kidneys cease to function properly, waste products accumulate in the blood, leading to symptoms like vomiting, itchy skin, extreme fatigue, blood in the urine, and swelling in the feet, hands, and ankles. Dialysis is recommended when there are clinical signs of severe loss of kidney function, with dangerously high levels of waste products in the blood.
In some instances, dialysis may be advised irrespective of whether the patient has begun to experience symptoms of uremia. Acute renal failure, often caused by a severe kidney infection leading to a sudden loss of kidney function, is a common reason why temporary dialysis may be required.
The two main types of dialysis, hemodialysis and peritoneal dialysis, eliminate waste and excess fluid from the blood in different ways.
Hemodialysis involves circulating the patient's blood through a system known as an artificial kidney. The device contains a semi-permeable membrane that allows the passage of molecules according to their electrochemical gradient, while preventing the escape of larger components like red blood cells and plasma proteins. Once the exchange is complete, the blood leaves the device and returns to the patient.
Peritoneal dialysis employs a membrane present inside the body, the peritoneum, similar to the semi-permeable membrane used in hemodialysis. During this type of dialysis, the dialysis fluid is introduced into the peritoneal cavity, facilitating an exchange of solutes between the blood flowing through the peritoneum's capillaries and the dialysis fluid.
Both hemodialysis and peritoneal dialysis achieve similar results, and the choice often depends on the patient's condition. However, each method has its own set of advantages and potential side effects, ranging from persistent fatigue, anemia, weakening of bones, itching, low blood pressure, muscle cramps, fluid overload, high blood pressure, high potassium levels, amyloidosis, infections, and weight gain.
Dialysis, while demanding, serves as a potential lifesaving measure. The success of dialysis in treating kidney failure depends on several factors, including the patient's age, any concurrent chronic diseases, and the cause of the disease. Unfortunately, dialysis can only compensate for the loss of kidney function to a certain extent and is not a permanent cure. Many patients remain on dialysis for a long period, with a kidney transplant being the ultimate goal for a significant minority. For those who are not eligible for a kidney transplant due to another serious health condition, dialysis will be a lifelong necessity.