Dialysis

What is Dialysis?
Dialysis is a method of removing impurities and wastes from the blood when the kidneys are unable to do so.  Dialysis comes in a variety of forms and it is important to work with your doctor to choose the type of dialysis that works with your lifestyle.  The two basic technologies are conventional hemodialysis where the blood leaves the body for purification and peritoneal (bloodless) dialysis that uses a special fluid to remove waste.

In Center Hemodialysis
In hemodialysis, the patient's blood is pumped from the body, through an artificial kidney and then returned to the body. The artificial kidney sends the patient's blood through thousands of tiny tubes that are bathed in a special fluid, called the dialysate. Waste products in the blood flow across the walls of the tubes into the dialysate, cleaning the blood.
In order for hemodialysis to work patients need a way to get blood out of the body, into the artificial kidney, and back in to the body. This pathway is called a "vascular access," or simply an "access." Most patients who choose hemodialysis get it done in a dialysis center. Dialysis is generally done three times a week and takes between three and four hours.

Nocturnal Hemodialysis
In-center nocturnal dialysis is a technique that allows for more prolonged dialysis sessions, often lasting 6 to 8 hours.  The prolonged dialysis allows for gentler fluid removal, which is helpful for patients with weak hearts or low blood pressure.

Patients arrive at the dialysis center in the evening and start their treatment from 8 to 9 p.m., and complete their treatment between 4 and 6 a.m. The patients receive dialysis either in a chair or bed; they typically bring their own bedding, wear pajamas, surround themselves with all the comforts of home and are able to sleep while receiving dialysis.

SCSP has prepared an informative article on nocturnal dialysis.
Click to read: Nocturnal Dialysis - A Better Way to a Healthy Life

Home Hemodialysis
At-home dialysis is an increasingly available choice. Patients who choose home dialysis undergo training at a home dialysis center. The dialysis done at home is usually done more often than three days a week. Patients who do home dialysis 5 or 6 days a week are much healthier than patients who receive dialysis 3 days a week so most physicians encourage the increased frequency.

We have an excellent video on the benefits of home dialysis.
Click to watch online:  Home Dialysis – Dr. Robert Provenzano

SCSP has prepared an informative article on home dialysis.
Click to read: Home Dialysis - Dr. Quresh Khairullah

The idea of getting started on home dialysis can seem overwhelming.alysis.
Click to read: Getting Started on Home Dialysis - Dr. Robert Provenzano

Peritoneal Dialysis
In peritoneal “bloodless” dialysis, special fluid, dialysate, is introduced into the abdomen through a plastic catheter into the belly. The fluid remains in the body for a few hours and removes wastes and toxins from the blood. The fluid is then drained from the belly and sent down the drain. Patients repeat this a few times a day every day. Peritoneal dialysis is done by the patient or family member at home and requires some training.

Dialysis Access
Patients must have a vascular access surgically placed prior to starting hemodialysis. Three different accesses available

• AV Fistula
• AV Graft
• Catneter

An AV fistula is a direct connection between the patient’s artery and one of their nearby veins.  This is the absolute BEST access a patient can have because it is all their own tissue.  The fistula resists clotting and infection.

An AV graft (sometimes called a bridge graft) is an indirect connection between the artery and vein, most commonly a plastic tube is used, but donated arteries or veins can also be used.

A catheter (also known as a permacath) is place into a large vein to allow dialysis.  A Catheter is a flexible, hollow tube that allows blood to flow in and out of your body.  They are most commonly used as a temporary access for up to three weeks.  It is generally placed when there is not enough time to allow a fistula to mature.