Dialysis
A form of medical treatment for those with malfunctioning kidneys is dialysis. When you suffer from kidney impairment, your kidneys are not able to purify blood as they are supposed to. This leads to a buildup of toxins and wastes in the bloodstream. By means of dialysis, waste products and superfluous liquid are taken away from the blood, substituting for the function of the kidneys.
Who Needs Dialysis
Individuals suffering from terminal renal disease or kidney failure could need to undergo dialysis. Injuries or illnesses such as hypertension, diabetes, and lupus can harm the kidneys and potentially lead to a kidney disorder.
Some people develop kidney problems for no known reason. Renal failure may be a chronic affliction, or it can come on abruptly in the aftermath of a major disease or harm. This kind of kidney failure could possibly vanish as you get better.
There are five stages of kidney disease. At stage 5 of kidney disease, medical specialists will view it as advance renal failure (ESRD) or kidney collapse.
At this juncture, the kidneys are performing about 10-15 percent of what they typically do. You could be reliant on either dialysis or perhaps a kidney transplant in order to remain alive. Some people undergo dialysis while waiting for a transplant.
What Do The Kidneys Do
Your kidneys are part of your urinary system. These two bean-shaped organs are located under the ribs on either side of the back. The kidneys remove harmful substances from your blood and send the filtered, nutrient-filled blood back into the circulatory system.
The kidneys produce urine that is then transported to the bladder through excretion of surplus liquid and waste. Your kidneys also help regulate your blood pressure.
Dialysis Services
- Patient-centered facilities. The center offers 24 private dialysis stations, three home-training rooms, two exams rooms and a centrally located nursing station. The design of the unit is intended to give you quiet space and the feeling of being in a private room, while allowing your care team to observe your dialysis session from the nursing station. In addition, online monitoring allows staff to follow your progress throughout the treatment.
- Collaboration to drive better patient outcomes. The Dialysis Center in Jacksonville, Florida, will be the home to a new renal care center of excellence being developed in collaboration with Baxter International Inc. Together they are developing a chronic kidney disease program focused on slowing the progression of kidney disease. They are also developing Baxter’s latest technologies to support the clinical and lifestyle needs of people with kidney disease.
- Home training program. A specially designed training area includes a bedroom with a shower and toilet facilities. A nephrologist oversees the training program, which is managed by an experienced home dialysis training nurse. The program is designed for people who desire more independence and control over their treatment options. If you’re trained to perform your dialysis at home, you’ll return to the center once a month for evaluation.
Hemodialysis Vascular Access
Hemodialysis involves a machine taking out blood from the body, running it through a dialyzer (an artificial kidney) to purify it, and putting the cleansed blood back into the body. It usually lasts between 3 and 5 hours and it may occur in either a clinical setting such as a hospital, or a dialysis center, on three occasions in the same week.
You can also do hemodialysis at home. It could be necessary for you to receive care in the comfort of your own home four to seven times in a week, but for shorter lengths of time during each instance. You have the option to opt for hemodialysis in the comfort of your own home during the night while you are asleep.
Undergoing chronic hemodialysis requires an easy access to your bloodstream, which is achieved:
- Through the blood vessels (called an arteriovenous fistula)
- By inserting a tube made from synthetic material that links an artery and a vein under the skin — a polytetrafluoroethylene (PTFE) graft
- By inserting a catheter in a vein (a venous catheter)
The type of hemodialysis vascular access best suited to an individual must be personalized. A surgeon in an operating room makes a vascular access. It is probable that a local numbing agent or general anesthetic will be administered.
A canal for the passage of blood (i.e. a fistula or graft) is ordinarily situated in the arm and can take several weeks or months to heal and be usable. The vascular access may be noticeable to other people.
Your vascular access is extremely important and needs to be taken care of in order for it to function correctly. A tube is normally inserted into the neck and it could be done by either a vascular surgeon or a radiologist specializing in interventional procedures.
Our vascular surgeons possess a great deal of aptitude and a long history of creating multiple types of vascular access as well as being pioneers in the advances of vascular access. Interventional radiologists who work for Mayo Clinic are proficient in the fields of imaging, clearing blockages and creating openings in the blood vessels.
Interventional radiologists also insert dialysis catheters. Vascular surgeons, interventional radiologists, and nephrologists join forces to ensure the highest level of access to healthcare.
At every dialysis appointment, your team of healthcare professionals will monitor your hemodialysis access to ensure it is functioning optimally. This section of the procedure aids in reducing unexpected stoppages or clogging.
Doctors who specialize in the circulatory system, such as vascular surgeons and interventional radiologists, are on hand to help place new dialysis access apparatuses, update existing access devices so they remain operational, and aid in unclogging and restoring fistulas or grafts.
Before Hemodialysis
Prior to hemodialysis, you will go through a small surgical treatment to make it simpler to get access to the bloodstream. You may have:
- Arteriovenous fistula (AV fistula): A surgeon connects an artery and vein in your arm.
- Arteriovenous graft (AV graft): If the artery and vein are too short to connect, your surgeon will use a graft (soft, hollow tube) to connect the artery and vein.
An AV fistula or graft will increase in size the attached artery and vein, thus making dialysis access simpler. They facilitate the speed at which blood enters and exits the body.
If dialysis is necessary urgently, your provider may put a slender tubing into a vein in your neck, torso or leg as a provisional approach.
Your provider will give you instructions on how to stop your fistula or graft from getting infected. This company will demonstrate to you the way to conduct hemodialysis at home in the event you decide to do it.
During Hemodialysis
During hemodialysis, the dialysis machine:
- Removes blood from a needle in your arm.
- Circulates the blood through the dialyzer filter, which moves waste into a dialysis solution. This cleansing liquid contains water, salt and other additives.
- Returns filtered blood to your body through a different needle in your arm.
- Monitors your blood pressure to adjust how fast blood flows in and out of your body.
After Hemodialysis
Some people have their blood pressure drop during or shortly after undergoing hemodialysis. You may feel nauseous, dizzy or faint. Other side effects of hemodialysis include:
Peritoneal Dialysis
Peritoneal dialysis involves utilizing the peritoneum, which is a thin wall of tissue in the abdomen, to filter blood through the utilization of a dialysis solution. This is a particular cleansing formulary made up of water, salt, and additional ingredients.
Peritoneal dialysis takes place at home. There are two ways to do this treatment:
- Automated peritoneal dialysis uses a machine called a cycler.
- Continuous ambulatory peritoneal dialysis (CAPD) takes place manually.
Before Peritoneal Dialysis
A few days before you begin your peritoneal dialysis process, you’ll have to go through a minor surgical procedure. A doctor puts a flexible, slim hose (catheter) through your abdomen and into the cavity that encloses the internal organs. This catheter stays in place permanently.
A healthcare professional will show you how to engage in peritoneal dialysis in the comfort of your own home, as well as provide methods to avoid contamination of the catheter insertion site.
During Peritoneal Dialysis
During peritoneal dialysis, you:
- Connect the catheter to one branch of a Y-shaped tube. This tube connects to a bag that has dialysis solution. The solution flows through the tube and catheter into the peritoneal cavity.
- Disconnect the tube and catheter after about 10 minutes, when the bag is empty.
- Cap off the catheter.
- Go about your usual activities while the dialysis solution inside the peritoneal cavity absorbs waste and extra fluids from the body. This process can take 60 to 90 minutes.
- Remove the cap from the catheter and use the other branch of the Y-shaped tube to drain the fluid into a clean, empty bag.
- Repeat these steps up to four times a day. You sleep with the solution in your stomach all night.
Some people prefer to do peritoneal dialysis at night. An automated peritoneal dialysis procedure can be done using a machine known as a cycler, which pumps the dialysis solution into and out of the body while the patient slumbers.
After Peritoneal Dialysis
The fluid in your abdomen can cause you to feel swollen or satisfied. It might feel uncomfortable, but the treatment isn’t painful. When your stomach is full of fluid, it may protrude more than normal.
The Potential Risks or Complications of Hemodialysis
Certain individuals experience difficulties with the AV fistula or transplant. It is possible to contract a contagious disease, suffer from impaired circulation of the blood or be obstructed by adhesions or a clump of coagulated blood.
Occasionally, the dialysis needle can become dislodged from your arm or a tube from the machine during the dialysis process. An alarm system is set up which will notify either you or medical personnel about any potential bleeding. The machine shuts down temporarily until the issue is resolved. This system protects you from blood loss.
The Potential Risks or Complications of Peritoneal Dialysis
Some people develop skin infections around the catheter. You may also run the risk of acquiring peritonitis, a type of infection which develops when bacteria are able to enter the stomach cavity via the catheter. You may experience fever, abdominal pain, nausea and vomiting.
Repeatedly inserting an abdominal catheter and filling the abdomen with fluid can lead to a weakening of abdominal muscles over a period of time. You may develop a hernia. This syndrome arises when a body part like the small intestine goes through the abdominal muscles.
You might notice a protrusion close to the navel or in the crease between the abdomen and the upper leg. Your doctor can repair a hernia with surgery.
Your body will take in dextrose, a type of sugar, when going through peritoneal dialysis by means of the dialysis solution. Eventually, an increase in sugar consumption can result in an increase in weight.
Your Dialysis Care Team
Nephrologist
A nephrologist is a doctor who has completed three years of internal medicine training and an additional two to three years of specialized training in nephrology (study of kidney diseases).
Transient Dialysis Support
Individuals on dialysis are normally evaluated for a short assessment of their dialysis procedure and present medical issues. Contact the Mayo Clinic Dialysis Center for requesting sufficient dialysis care. The Mayo personnel need to communicate with the nurses at your present dialysis center.
The following information will be requested:
- Patient name, date of birth, Social Security number
- Dates patient expects to be in Jacksonville
- Cause of renal failure
- Current dialysis treatment orders
- Access information
- Known allergies
- Information regarding patient stability
- Information regarding infection precaution
- Ongoing pertinent medical problems
- Recent history and physical
Those in need of peritoneal dialysis must secure any necessary materials prior to visiting a dialysis facility.