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BLK Centre for Renal Sciences & Kidney Transplant >> Treatment Offered >> Dialysis

Dialysis

Dialysis

It replicates a normal kidney’s functions. This is used for the treatment of chronic kidney disease because kidney is incapable of performing all kinds of functions.

The choice between hemo or peritoneal dialysis is influenced by a number of considerations such as availability, convenience, underlying medical problems home situation, and age.This choice is best made by discussing the risks and benefits of each type of dialysis with your concerned doctor and his support staff.

When to start dialysis?

It is recommended that dialysis begin well before kidneys disease has advanced to the point where life threatening complications affecting the brain, heart and lungs occur. If one starts dialysis very late, than the quality of life is not significantly improved even after receiving regular dialysis.

Emergency dialysis is usually given when
Blood tests reveal very high BUN/Serum Creatinine

  • Patient has severe shortness of breath due to-
    • Fluid overload
    • Severe metabolic acidosis
  • Life threatening hyperkalemia (high potassium levels in blood)
  • Bleeding diathesis due to uremia
  • Pericarditis, i.e. fluid collection around the heart
  • Patient is in altered mental state or has motor weakness due to involvement of nerves

However a patient is advised to go for early dialysis electively and not to wait for an emergency, as the emergency dialysis has much higher mortality and morbidity risks.

Preperation for Hemodialysis

Mental preparation for hemodialysis should be made well in advance before its need arises.

Primary AV fistula is the preferred type of vascular access.
It requires a surgical procedure that creates a direct connection between an artery and a vein. During dialysis, two needles are inserted into the fistula vein. Blood flows out through one needle, circulates through the dialysis machine, purified and flown back through the other needle.One should get a fistula created usually two to four months before the expected start of life saving hemodialysis.This will save the patient from temporary catheters, which are more prone to cause infections, injuries and clotting.

Home Hemodialysis

In foreign countries, patient and their relatives are taught to do hemodialysis at home usually at night time before sleeping. This is done anywhere from 3 to 7nights a week. One has to arrange for a hemodialysis machine, water supply unit, disposable, medicines and some chemicals. A separate room is also required. The patients remain in touch with their dialysis center by telemetry or otherwise. In India due to costs and other issues this modality has yet to take off, however BLK is pledged to provide the home hemodialysis to any person willing for it.Full technical support will be given by department of nephrology BLK Super Speciality Hospital.

CAPD (Chronic Ambulatory Peritoneal Dialysis)

More common is the home CAPD in India.
A small plastic catheter is inserted in the patients’ abdomen by a simple surgery. The patient with his attendants are taught how to instill dialysis fluid in his abdomen through this catheter and then drain the used fluid out four hours later. This process has to be done thrice a day with all due precautions. The advantage of this therapy is that

  • It can be done in the home environment: so time, money and energy spent in traveling to hospital thrice a week, for hemodiaysis, is avoided.
  • There are fewer requirements for blood transfusion
  • Generally less restriction is placed on food and fluid intake
  • It is a safer modality for patients with advanced cardiac, neurological disease

Patient can pursue a normal lifestyle. All the types of Dialysis (Hemodialysis, SLEDD, CRRT) are done at this centre. Besides this Nocturnal Hemodialysis,Home dialysis, Bed-side Renal Replacement therapies in ICU and other critical care areas are also provided

Follow up after kidney Transplant

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