When is Kidney Dialysis Necessary?

Patients typically require dialysis when the waste products in their bodies become so high that they begin to feel sick and disturbed. The level of waste products usually accumulates slowly.

Doctor will measure several blood chemistry levels to help to decide when dialysis is needed. The two major blood chemistry levels measured were the "creatinine level" and the level of "Blood Urea Nitrogen" (BUN).

The increase in both parameter is an indicator of the decreased ability of the kidneys to cleanse the body of waste products.

Doctors use urine test, especially "creatinine," to measure the level of kidney function. Patient keeps the urine in a special container for a full day.

The waste products in urine and blood are estimated by measuring creatinine. By comparing blood and urine levels of these substances, doctors have an accurate idea of ​​how well the kidneys work.

This result is called "creatinine clearance". Usually, when creatinine clearance falls into the 10-12 cc / min range, the patient needs dialysis.

Doctor also uses another indicator of patient's status to decide on the need for dialysis. If the patient has an inability to rid excess water from their body, or complains they have problems with heart, lungs, or stomach, or difficulties with taste or sensation in their legs, dialysis may be indicated even if creatinine clearance does not reach 10-12 cc / min.

What type of dialysis is available?

There are two main types of dialysis: "peritoneal dialysis" and "hemodialysis".

Hemodialysis uses a special type of filter to remove waste products from the blood, whereas Peritoneal dialysis uses fluid placed into the patient's abdominal cavity through a special plastic tube to remove excess waste and liquid from the body.

Hemodialysis.

During hemodialysis, the blood from the patient's body is passed through a dialysis machine filter, called a "dialysis membrane." For this procedure, the patient will have a special plastic tube placed between the artery and vein in the arm or leg (called "Gortex graft").

Sometimes, a direct connection is made between an artery and a vein in the arm. This procedure is called "Cimino fistula". The needle is then placed in the graft or fistula, and blood is passed to the dialysis machine, through the filter, and back into the patient's body.

If the patient needs dialysis before a graft or if there is a fistula placed, a large diameter catheter is placed directly into the large blood vessels in the neck or leg for dialysis.

In a dialysis machine, the liquid solution on the other side of the filter receives the waste product from the patient.

Peritoneal dialysis.

Peritoneal dialysis uses the inner abdominal tissue (abdominal cavity) of the patient to act as a filter. The abdominal cavity has a special membrane called the peritoneal membrane.

A plastic tube called a "peritoneal dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special liquid is then rinsed into the abdominal cavity to wash around the intestine.

The peritoneal membrane acts as a filter between this fluid and the bloodstream. By using different types of solutions, waste products and excess water can be removed from the body through this process.