The kidneys are responsible for filtering out waste substances in our body and excreting them through urine. The also help to control blood pressure and regulate the level of chemicals in the blood; such as sodium, potassium and bicarbonate. When the kidneys fail to perform these functions either due to disease or injury, one may need to start dialysis.

What is dialysis?

Dialysis is a treatment that filters and purifies the blood using a machine. There are 2 main types of dialysis; namely haemodialysis and peritoneal dialysis.

Haemodialysis

• The most common type, that uses an artificial kidney (hemodialyzer) to remove waste products and chemicals from the blood.
• The blood is removed from the body and filtered through the hemodialyzer. Then the filtered blood is returned to the body.
• A vascular access will be made to get the blood to flow to the artificial kidney.
• For long term dialysis treatment, an arteriovenous (AV) fistula which connects an artery and a vein is used. For short term use, a catheter may be inserted into the large vein in your neck or leg.
• Haemodialysis treatment usually lasts about four hours and is done three times per week.

Peritoneal dialysis

• Involves surgery to implant a catheter into the abdomen.
• Uses a dialysate (fluid) which is placed into a patient’s abdominal cavity to remove waste products and fluids from the body.
• There are a few different types of peritoneal dialysis such as the continuous ambulatory peritoneal dialysis and the automated peritoneal dialysis.
• In the former, the abdomen is filled and drained multiple times each day, whereas the latter uses a machine to cycle the fluid in and out of the abdomen.
• Can be done at home.

Watch the video to understand more about haemodialysis and peritoneal dialysis.

Risks associated with haemodialysis

• Hypotension (low blood pressure)
• Anaemia
• Muscle cramps
• Hyperkalemia (high blood potassium level)
• Sleep problems
• Access site complications such as infection, narrowing or blockage

Risks associated with peritoneal dialysis

• Peritonitis (infection of the abdominal lining)
• Weight gain
• Hernia

If you have questions on dialysis, don't be afraid to speak to your doctor regarding the appropriate treatment for you. 

References:

1. Dialysis | MedicineNet
2. Dialysis | National Kidney Foundation
3. When Do I Need Dialysis | WebMD

Image credit:

1. https://images.benefitspro.com/benefitspro/article/2018/02/27/kidneys77.jpg
2. https://villa-medica.com/wp-content/uploads/2017/08/villa-medica-chronic-kidney-disease-infographic-1-compressor.jpg
3. https://www.renalandurologynews.com/wp-content/uploads/sites/22/2019/01/thinkstockphotos119255593_918812.jpg
4. https://dev.rodpub.com/images/180/297_main.jpg

Written by

Dr Amirah Ekhsan