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 c
hemical solution known as dialysate, the treatment removes waste products and ex
cess fluids from the bloodstream, while maintaining the proper chemical balance
of the blood. There are two types of dialysis treatment : hemodialysis and perit
oneal dialysis.

Peritoneal dialysis (PD) is a treatment for patients with severe chronic kidney
failure. The process uses the patient's peritoneum in the abdomen as a membran
e across which fluids and dissolved substances (electrolytes, urea, glucose, alb
umin and other small molecules) are exchanged from the blood. Fluid is introduc
ed through a permanent tube in the abdomen and flushed out either every night wh
ile the patient sleeps (automatic peritoneal dialysis) or via regular exchanges
throughout the day (continuous ambulatory peritoneal dialysis). PD is used as an
alternative to hemodialysis though it is far less common. It has comparable ri
sks and expenses, with the primary advantage being the ability to undertake trea
tment without visiting a medical facility. The primary complication with PD is a
risk of infection due to the presence of a permanent tube in the abdomen.
Nursing care for peritoneal dialysis (PD) patients
Adapt from nephrology nursing practice recommendations developed by Canadian Ass
ociation of Nephrology and Technology (CANNT) based on best available evidence a
nd clinical practice guidelines, a nephrology nurse should perform [16]:
Pre-operatively Identify a patient s ability and available support system before t
he surgery and identify the learning gap.
Post-operatively Provides and educates a patient on exit site care.
Dialysis adequacy Assesses signs of symptoms of inadequate dialysis when doing h
ead to toe assessment on an ongoing basis.Encourages and educates a patient the
importance of adequate dialysis.
Peritoneal dialysis (PD) treatment and complications Assess signs and symptoms o
f complications, such as exit infection, peritonitis. Assesses a patient s knowled
ge level, identify learning gap and develop a teaching plan collaterally.
Medication Management and infection control practice Develop a suitable medicati
on regimen under patient s cooperation. Follows the unit protocol of infection con
trol and also educates the patient the critical importance of infection control
practice.

hemodialysis (also haemodialysis) is a method for removing waste products such a

s creatinine and urea, as well as free water from the blood when the kidneys
are in renal failure. Hemodialysis is one of three renal replacement therapies (
the other two being renal transplant; peritoneal dialysis).
Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is
conducted in a dialysis outpatient facility, either a purpose built room in a ho
spital or a dedicated, stand alone clinic. Less frequently hemodialysis is done
at home. Dialysis treatments in a clinic are initiated and managed by specialize
d staff made up of nurses and technicians; dialysis treatments at home can be se
lf initiated and managed or done jointly with the assistance of a trained helper
who is usually a family member.[1]
 Nursing cares for hemodialysis patient
Adapt from nephrology nursing practice recommendations developed by Canadian Ass
ociation of Nephrology and Technology (CANNT) based on best available evidence a
nd clinical practice guidelines, a nephrology nurse should perform [28]:
Hemodialysis Vascular Access: Assess the fistula/graft and arm before, after eac
h dialysis or every shift: the access flow, complications Assess the complicatio
n of central venous catheter: the tip placement, exit site, complications docume
nt and notify appropriate health care provider regarding any concerns. educates
the patient with appropriate cleaning of fistula/graft and exit site; with recog
nizing and reporting signs and symptoms of infection and complication.
Hemodialysis adequacy: Assesses patient constantly for signs and symptoms of ina
dequate dialysis. Assesses possible causes of inadequate dialysis. Educations pa
tients the importance of receiving adequate dialysis.
Hemodialysis treatment and complications: Performs head to toe physical assessme
nt before, during and after hemodialysis regarding complications and access s secu
rity. Confirm and deliver dialysis prescription after review most update lab res
ults. Address any concerns of the patient and educate patient when recognizing t
he learning gap.
Medication management and infection control practice: Collaborate with the patie
nt to develop a medication regimen. Follow infection control guidelines as per u
nit protocol.