Dialysis is a treatment method for people whose kidneys do not work well enough. People whose kidneys do not work cannot remove the wastes, excess water and minerals accumulated in their blood from the body. Dialysis is an artificial system that performs this function instead of the kidney for these patients. Approximately 15.7% of Türkiye's population has chronic kidney disease. Approximately 9 million people in our country suffer from chronic kidney disease. This means that one out of every 6-7 adults has a chronic kidney disease.
What is Dialysis?
One of the most important functions of the kidneys is to remove wastes and toxins from the body due to various reasons. In addition, it also serves to provide water and mineral balance. It expels wastes, excess water and minerals from the body as urine. In people whose kidneys do not work properly and adequately, these functions cannot be fulfilled. Waste and minerals that cannot be thrown out begin to accumulate in the body. The most appropriate treatment for these patients is dialysis treatment. Because dialysis is an artificial system that performs the natural function of the kidney. It is also called “renal replacement therapy” because it performs the excretion process instead of the kidney.
The function of the kidneys is not limited to excretion only. The kidneys also have functions to secrete important hormones and substances. The kidneys secrete hormones such as erythropoietin and renin. It plays a role in activating vitamin D. In the case of chronic kidney disease, this function of the kidney cannot be fulfilled. However, although dialysis is called renal replacement therapy, it cannot fulfill the secretion function of the kidney.
Dialysis Process
There are special treatment centers and areas for dialysis. These places are called dialysis centers. Dialysis treatment has two basic dialysis methods for chronic kidney patients: hemodialysis and peritoneal dialysis. CRRT dialysis, known as continuous renal replacement therapy, is mostly used for intensive care patients who develop acute renal failure; Also known as hemofiltration. Hemofiltration is performed 12-24 hours a day, every day of the week.
Dialysis Types
There are special treatment centers and areas for dialysis. with this place r is called dialysis center. Dialysis treatment has two basic dialysis methods for chronic kidney patients: hemodialysis and peritoneal dialysis. CRRT dialysis, known as continuous renal replacement therapy, is mostly used for intensive care patients who develop acute renal failure; Also known as hemofiltration. Hemofiltration is performed 12-24 hours a day, every day of the week.
Hemodialysis The most common dialysis method is hemodialysis. An artificial device called “hemodialyzer” is used to remove wastes and excess water from the body. The blood enters the hemodialyzer from the body, after the hemodialyzer filters the blood, it is returned to the body. Vascular access is needed to provide this blood flow between the hemodialyzer device and the body.
There are 3 types of vascular access:
Hemodialysis session lasts 3-5 hours and is performed three times a week. It can also be completed by doing 4-5 times a week with shorter sessions. Factors affecting the duration of hemodialysis sessions; body size, the amount of waste accumulated in the body and the general health status of the patient before the session.
Peritoneal Dialysis In order to perform peritoneal dialysis, a peritoneal dialysis catheter is surgically placed in the abdomen of the dialysis patient. The biggest difference from hemodialysis is that the membrane used to filter the blood is not an artificial device but its own peritoneum. During the treatment, a special liquid called “dialysate” is sent to the peritoneum. Absorb the dialysate waste er. After collecting the waste in the blood stream, dialysate is withdrawn from the abdominal cavity. Peritoneal dialysis takes several hours and needs to be done 4-6 times a day. The biggest advantage is that it can be done while the patient is asleep or awake.
How is Dialysis Performed?
Dialysis machines consist of a special liquid called dialysate and a series of membranes to clean the blood. Waste substances in the blood of the dialysis patient are filtered by passing through membranes. Waste materials pass into the dialysate fluid. The filtered blood is returned to the patient's body while the dialysate fluid containing the waste materials is pumped out of the dialysis machine. Dialysis is not a painful procedure, but the patient may experience dizziness and muscle cramps during the procedure. Post-dialysis side effects can be listed as hypotension, muscle cramps, clot formation, infection, weight gain and itching.
Who Should See Dialysis Treatment?
Kidney failure is generally classified under two subheadings: acute and chronic renal failure. While kidney failure that develops suddenly is called acute, the long-term damage to the kidney by gradual damage is called chronic. People with chronic kidney disease or end-stage kidney disease (ESRD) need dialysis. Diseases such as hypertension, diabetes or lupus can damage the kidney in the long run. However, in some people, the causes of chronic kidney failure cannot be identified. Chronic kidney disease is examined in five stages. The fifth stage is called end-stage renal disease (ESRD). At this point, the kidneys can only perform 10 to 15% of their normal functions. At this stage, patients either need a renal replacement therapy such as dialysis or patients need a kidney transplant. Patients waiting for a transplant also need dialysis during this time. The last stage of dialysis patients requires kidney transplantation. When deciding on dialysis, the patient's symptoms along with kidney functions are taken into account. One of the most important findings of chronic kidney diseases is edema. The accumulation of water in the lungs in dialysis patients is also related to edema and excess water retained in the body.
Frequently Asked Questions About Dialysis
How Percent Does the Kidney Work? Dialysis Can Be Entered? i, required when the patient's kidneys can no longer handle the body's waste and water load on their own. This happens when the picture of end-stage kidney disease develops. When the kidneys perform only 10-15% of their functions, the patient now needs dialysis treatment. Glomerular filtration rate (GFR) is less than 15 ml/min in the final stage. There is no definite serum creatinine level that determines the limit for dialysis. Dialysis decision is made according to the patient's symptoms and how well the kidney can function. GFR is calculated based on creatinine clearance. It cannot be decided by the serum creatinine level alone.
How Many Urea Is Dialysis? There is no set urea level for entering dialysis. However, at abnormally high urea levels (>200 mg/dl), the patient has signs and symptoms. This may also require dialysis. Again, dialysis cannot be decided with the urea level alone. A comprehensive evaluation is required for the dialysis decision. In general, hemodialysis sessions last 3-5 hours, while peritoneal dialysis takes 1-2 hours. While hemodialysis is performed 3 times a day for 1 session, peritoneal dialysis is performed 5 times a week for 4-6 sessions a day.
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