Dialysis is a process used for filtration of blood. Many times, the kidneys are not able to function properly due to disease, which requires the body to be put on dialysis to maintain fluid and electrolyte balance within the body. There are two kinds of dialysis, Hemodialysis and Peritoneal Dialysis. For critical ill admitted patients sustained low efficiency dialysis and Continuous Renal Replacement Therapy are done as per need of patients. Dr. Rajesh Goel offers dialysis for kidney patients being one of the best kidney specialists in India.
Hemodialysis is one of the important therapy for renal replacement. In this the patients who are suffering from end stage renal disease (ESRD) or chronic kidney disease stage 5 undergo dialysis.
Hemodialysis is a form of dialysis in which harmful toxins are partially removed also excess water is taken out. It also controls important electrolytes like sodium, potassium. It controls increased phosphorus levels, increased acid level in the blood. It improves appetite, volume overload, swelling in the body. It also improves brain function, heart function. It also strengthens bones and muscles.
It also in hospital it has to visit in hospital twice or thrice in a week.
That is why in some areas still hemodialysis facility is not available. So, it is not practical for patients living in remote areas to get dialysis done. It is a painful procedure because for hemodialysis needless are pricked.
Chances of blood related infections like hepatitis b, hepatitis c etc.
Need, a vascular access because in some patients a vascular access is a problem.
Rapid correction and rapid fluid removal which is not possible with peritoneal dialysis
Use of heparin (I.e. anticoagulant) which prevents clothing of blood and increases the risk of bleeding
it is a form of dialysis in which a special fluid (peritoneal dialysis and fluid) is inserted into abdomen through a peritoneal dialysis catheter and then this fluid is kept in the abdomen for 6-12 hours (somewhere it is a time for which the fluid is kept in the abdomen i.e. in between inflow and outflow time) dual time .Then this fluid, will remove toxin, extra fluid and control electrolytes. This cycle of inserting and removing fluid is a continuous process for whole day or for 24 hours.
In this the inflow and outflow of the fluid is controlled through automated machine and which is usually done during night time and it exchanges are of shorter period of time could be combined 1 or 2 manual exchanges with fluid. During day time the benefit of CAPD is slow ongoing dialysis which is more physiological, no vascular access is required.
It is painless procedure need not to require to go to hospital can be performed at home.
It is the treatment for kidney failure. A special kind of fluid which is sterile in nature, introduced into the abdomen through a permanent tube. This is placed in the peritoneal cavity. Fluid circulates through abdomen to drain out impurities from blood vessels in the peritoneum; it is than drained from the body.
PD can be done at home, work, or even on trips. But it requires special kind of supervision. PD patient also requires regular working with dialysis technician, nephrologist, dialysis nurse, and dietician.
Two types of peritoneal dialysisRegular maintenance hemodialysis thrice weekly.
If patient has good urine output, stable renal functions, minimal symptoms, potassium and phosphorus are controlled and inter-dialytic weight gain is not much than patient can come twice weekly.
CAPD | APD |
Performed for 24 hours | Mainly during sleeping time |
Less costly | Very costly |
Chances of technique failure is more (ultrafiltration) | Chances of techniques (ultrafiltration) failure is less |
Can more around with dialysis going on | The patient is continuously connecting with machine, so can’t move around. |
Chances of infection is high | Chances of infection is less |
Hemodialysis | Peritoneal dialysis |
Blood related therapy | Water based therapy |
Usually done is hospital settings | Done at home |
More dietary restrictions | Less dietary restrictions needed |
No protein loss | High protein loss leads to malnourishment |
Painful | Not painful |
Needs vascular access | Needs peritoneal dialysis catheter |
Cost varies but less costly than peritoneal dialysis | More costly |
Chances of blood related infections | More chances of peritonitis |
Chances of low BP and cardiac arrythmia | Less risk of hemodynamic instability and increased sugar levels |
Less preferred modality for pediatric cases. | Preferred modality in pediatric cases. |
SLED | CRRT |
Done with conventional hemodialysis machine | Done with special machine |
Needs less man power | Needs more man power and expertise |
Less costly | More costly |
It is intermittent form of dialysis | It is a continuous form of dialysis.Lasting for 2-4 days |
More chances of hypotension | Less chances of lower blood pressure |