What is Hemodialysis and Peritoneal Dialysis?

in plain laymen's terms

hemodialysis is the process of blood being filtered of toxins and excess fluids by a machine thru a "shunt" site inserted in the arm when a person has kidneys that do not function properly as in chronic renal failure

it is used for long term treatments- usually for life

and varies by need from 1 to 3 times a week for life at a dialysis unit or center

it acts like the kidneys

Peritoneal dialysis is the process of infusing special patient specific solutions to the abdomenal cavity over a period of hours or days to also remove toxins and excess fluids which is either used before a person is found to require hemodialysis or for the short term treatment of a certain kidney problem

each bottleof

the solution ( there are a series of bottles- some may have heparin added) is infused into the abdomenal cavity over a specific time period- retained for a specific time and slowly drained by gravity to a collection bag at the bedside

the amount drained is compared to the amount infused to determine if the patient is retaining or releasing more fluid than is infused this can be done at the patient's bedside

home or work

I have been doing haemodialysis and peritoneal dialysis for years now. Let me explain each renal replacement therapy.

In haemodialysis, you need to have a vascular access before you are able to do the process. The access can be an arteriovenous fistula or a gortex graft that is created on the arm or the groin. In arteriovenous fistula, the artery and vein is joined together. The most common arteries that is used are the cephalic vein and brachial artery or the cephalic vein and the radial artery on the wrist or forearm. A gortex graft is a man-made tube that is inserted to connect an artery to a vein. In some cases, a person does not have a good vein thus a fistula or gortex is not appropriate for them. They are inserted with a vascular catheter either on the subclavian or internal jugular vein. Now you can perform haemodialysis with the above access.

Haemodialysis is used for people with Chronic and end-stage renal disease. The patient is attached to a heamodialysis machine which then removes toxins and excess water in the body. A dialyser or what we call the artificial kidney removes toxins and water via the process or osmosis, diffusion and convection thus the blood that is returned back to the body is clean. A buffer of bicarbonate is used during the procedure. Since, the kidney is not functioning, the haemodialysis machine does that work.

Before peritoneal dialysis is done, we need a permanently implanted catheter (such as tenckhoff catherter) that will be inserted in the tummy to access the peritoneum. The peritoneum is a semi-permeable membrane and it also protects our abdominal organs. During peritoneal dialysis, a fluid which contains glucose (or in some cases a starch derivative) is instilled in the peritoneum. The glucose will aid in removing toxins and excess water in the body. Peritoneal dialysis also uses the same process of osmosis, diffusion and convection. The procedure can take from 20-45 minutes. Peritoneal dialysis can be done at home and at work.

If you have more questions, feel free to message me.

1

Peritoneal dialysis is done thru your peritoneal cavity. You do this type of dialysis at home. They have two kinds of this too, one you do 4 x a day, everyday, and the other you do every day but at night while you are sleeping. They put a catheter (tube) out of your stomach, you have a pole with a bag of dextrose (fluid) that is hanging and a bag on the floor, you hook your tube into it and empty out the contents of your stomach into the bag on the floor and you fill your stomach up with the dextrose, you repeat this every 4-6 hours, 4 times day. Hemodialysis is done at a center, usually 3 days a week for about 3-4 hours. The dialysis techs/nurses take care of hooking you up. This dialysis is done by filtering our your blood thru a machine. You have an access in your neck or arm to do this.

2

BOth methods are used for renal failure, it is because the kidneys can no longer filter out the waste products of the body of urea, creatinine which are product of protein and muscle metabolism. When waste products accumulate they can be harmful and may cause encephalopathy or coma. Dialysis uses principles of osmosis and diffusion. Osmosis is movement of SOLVENT or liquid or water from an area of low to high solute (dissolved particles) concentrations, diffusion is movement of SOLUTE to an area of high to low amounts of SOLUTE, in other words in osmosis, water or other solvents move to an area which has more dissolved particles or the are which is more concentrated while in diffusion, solute move from an area where it is abundant to an area where there is little or no solute at all and both processes need a semi permeable membrane, a membrane that only allows certain substances to pass through.

In hemodialysis, hemo meaning blood, the patient's blood is circulated into a machine, the machine serves as the semi permeable membrane and contains a solution with a low concentration of waste products therefore the waste products transfer from the body to the machine through diffusion ridding the body of waste products, and since if a person is with renal failure, he cannot excrete fluids or urine effectively, excess water from the body must be also eliminated and is transferred to the machine through osmosis. Hemodialysis requires a fistula, tunnel or catheter so that blood from the body can pass through and into the machine and circulate back to the body either a gortex fistula in the extremities usually in the arms or an intrajugular catheter in the neck. Hemodialysis is more invasive because it requires puncture into the blood systems and should be used with caution on patients with cardiovascular diseases because blood leaves the body the person may suffer from hypotension or low blood pressure. The person is also prone to infection because there is an access point for microorganisms directly in the blood. But the main advantage of hemodialysis is that it is faster than peritoneal dialysis.

Peritoneal dialysis uses the peritoneum the membrane that encloses the abdominal organs using it this time as its semi permeable membrane, a dialysate solution is instilled into the peritoneal cavity (induction phase 10min.) and allowed to stay for a period of time (equilibration phase about 30 min.) and to which this time there is movement or exchange of substances from the blood vessels in the abdoment in which waste products go to the dialysate solution and is then drained (about 20 min.) from the peritoneal cavity to evacuate the waste products. The major advantage is that it requires no other special equipment just an IV like bag with dialysate solution and a puncture or catheter in the abdomen and can be done anywhere and the person may continue with his daily activities but the disadvantage is that it takes a significantly longer time to achieve the filtering desired than with hemodialysis

hope this helps contact me if you need more info

Hemodialysis is cleansing the blood. Dialysis can be done in the arm or peritoneal dialysis is done through the abdomen.

What Is Hemodialysis