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| Image Source: nh.org.au |
• Is the process of cleaning the blood by removing wastes and fluid that build up when the kidneys fail.
• Is a way to replace some, but not all, kidney functions.
• The goal of dialysis is to help keep people with kidney failure as healthy as possible.
• Dialysis can't fully clean the blood.
Normal Kidney Function Compared to Dialysis
| Kidney | Dialysis |
| Removes all excess fluid each day | Removes some fluid on treatment days |
| Removes waste product each day | Removes some wastes on treatment days |
| Control electrolyte and acid/base | Helps restore electrolyte and acid/base balance |
| Controls blood pressure by fluid removal, sodium balance, and hormonal action | Helps control blood pressure by removing fluid and balancing sodium on treatment days |
| Makes erythropoetin, a hormone that triggers the bone marrow to make red blood cells | Can't make erythropoetin, but recombinant or genetically engineered erythropoetin is given |
| Controls calcium / phosphorus balance each day | Can change serum calcium levels somewhat by adjusting calcium in dialysate, can remove some phosphorus, but not as well as healthy kidney |
| Plays a role in hormonal balance | Has little, if any, effect on hormones |
| Activates vitamin D | Cannot activate vitamin D, vitamin D sterols can be given. |
• Blood is pumped out of the patient's body, through an artificial kidney, or dialyzer, then back into the patient.
• Both blood and dialysate fluids are pumped through different parts of the dialyzer at the same time.
• A semi permeable membrane keeps the blood and the dialysate from mixing.
• Excess water and wastes pass out of the blood through pores in the membrane, into the dialysate.
• The used dialysate is sent down a drain.
• Only a small amount of blood is out of the body at one time.
In-center Hemodialysis
• Some patients feel safer getting treatment in a center with nurses and technicians there to help.
• They like the chance to meet other people who need dialysis and may make friends at the center
• Patient has days off between treatments not to think about dialysis.
Conventional Hemodialysis
• Patients and their partners are trained for a few weeks in how to put in needles, order supplies, run the machine, take blood samples, report problems, and respond to emergencies.
Nocturnal Hemodialysis
• Patients are trained to do their treatments from 3-7 nights each week, for about 8 hours, while they sleep
• Special connectors keep the needles from coming out in case patients toss or turn.
• Bedwetting alarms, placed beneath the needle insertion area, may be used to detect moisture and wake the patient up if even a drop of blood is lost.
• In some programs, the machine is linked by a modem to the hospital so a nurse or technician can follow each treatment.
• Patients who receive 48 hours of treatment each week ate a normal diet and had normal blood pressure without drugs.
• They did not need phosphate binders.
• Most had no fluid limits.
• They also had fewer symptoms - including less fatigue, cramping, dizziness, shortness of breath, or feeling cold.
• They felt more in control, and had better physical functioning.
• They have less heart damage than patients on conventional in-center hemodialysis .
• Longer treatments also remove much more b2m, the protein that causes amyloidosis
In-center nocturnal Hemodialysis
• Patient sleep in the center while getting their treatment.
• They get about 24 hours of treatment a week instead of the 9-12 they would normally get in-center
Short Daily Hemodialysis
• 2-3 hours treatment done 5-7 days per week
Newest type of home Hemodialysis
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