DEFINITION OF DIALYSIS: Dialysis treatment replaces the function of the kidneys, which normally serve as the body's natural

filtration system.

Through the use of a blood filter and a chemical solution known as dialysate, the treatment removes waste products and excess fluids from the bloodstream, while maintaining the proper chemical balance of the blood. Methods of therapy include 1. hemodialysis, 2. continuous renal replacement therapy and 3. various forms of peritoneal dialysis

NEED FOR DIALYSIS : The need for dialysis may be acute or chronic. Acute dialysis is indicated when there is a high and rising level of serum potassium, fluid overload, or

impending pulmonary edema, increasing acidosis, pericarditis, and severe confusion.

It may also be used to remove certain medications or other toxins(poisoning or medication overdose) from the blood.

Chronic or maintenance dialysis is indicated in chronic renal failure, known as end-stage renal disease (ESRD), in the following instances: the presence of uremic signs and symptoms affecting all body systems nausea and vomiting, severe anorexia, increasing lethargy, mental confusion, hyperkalemia, fluid overload not responsive to diuretics and fluid restriction, and a general lack of well-being.

An urgent indication for dialysis in patients with chronic renal failure is pericardial friction rub. Patients with no renal function can be maintained by dialysis for years.

HEMODIALYSIS 1. Hemodialysis is performed to remove toxic wastes from the blood of patients in renal failure.

2. This potentially life-saving procedure removes blood from the body, circulates it through a purifying dialyzer and then returns the blood to the body. It is used for patients who are Acutely ill and Require short-term dialysis (days to weeks) and

For patients with ESRD who require long-term or permanent therapy.

A dialyzer (once referred to as an artificial kidney) serves as a synthetic semi permeable membrane, replacing the renal glomeruli and tubules as the filter for the impaired kidneys.

Patients receiving hemodialysis must undergo treatment for the rest of their lives or until they undergo a successful kidney transplant. Treatments usually occur three times a week for at least 3 to 4 hours per treatment

PRINCIPLES OF HEMODIALYSIS Diffusion, osmosis, and ultrafiltration are the principles on which hemo dialysis works COMPLICATIONS OF HEMODIALYSIS:

The patient is subject to a number of problems and complications.

One leading cause of death among patients undergoing maintenance hemodialysis is 1. Atherosclerotic cardiovascular disease. Disturbances of lipid metabolism 2. Heart failure, 3. coronary heart disease and 4. anginal pain, 5. stroke, 6. peripheral vascular insufficiency 7. Anemia and fatigue contribute to diminished 8. physical and emotional well-being,

9. lack of energy and drive, and 10. loss of interest. 11. Gastric ulcers and other gastrointestinal problems 12. . Disturbed calcium metabolism leads to renal osteodystrophy that produces bone pain and fractures.

Other problemsinclude : 1. fluid overload associated with heart failure, malnutrition, 2. infection, 3. neuropathy, and 4. pruritus. 5. Up to 85% of people undergoing hemodialysis experience major sleep problems .

CONTINUOUS RENAL REPLACEMENT THERAPIES: 1. Continuous arteriovenous hemofiltration (CAVH) 2. Continuous arteriovenous hemodialysis (CAVHD) 3. Continuous venovenous hemofiltration (CVVH) 4. Continuous venovenous hemodialysis (CVVHD)

PERITONEAL DIALYSIS

1. The goals of peritoneal dialysis are to remove toxic substances and metabolic wastes and to re-establish normal fluid and electrolyte balance. 2. Peritoneal dialysis is the treatment of choice for patients with renal failure who are unable or unwilling to undergo hemodialysis or renal transplantation.

 COMPLICATIONS OF PERITONNEAL DIALYSIS:

Peritonitis leakage of dialysate through the catheter site may occur bleeding

LONG-TERM COMPLICATIONS Hypertriglyceridemia, abdominal hernias (incisional, inguinal, diaphragmatic, and umbilical), It also aggravates symptoms of hiatal hernia and hemorrhoids. Low back pain and anorexia from fluid in the abdomen and constant sweet taste related to glucose absorption may also occur.

CONCLUSION: Dialysis treatment replaces the function of the kidneys, which normally serve as the body's natural filtration system. Through the use of a blood filter and a chemical solution known as dialysate, the treatment removes waste products and excess fluids from the bloodstream, while maintaining the proper chemical balance of the blood.