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Dialysis

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Dialysis

  1. 1. DIALYSISDone by:J.Manasia
  2. 2. Dialysis… a method of removing toxic substances (impurities or wastes) from the blood when the kidneys are unable to do so. most frequently used for patients who have kidney failure, but may also be used to quickly remove drugs or poisons in acute situations. This technique can be life saving in people with acute or chronic kidney failure.
  3. 3. Dialysis: Methods  Hemodialysis Peritoneal Dialysis
  4. 4. Hemodialysis… A dialysis process which requires a machine to transport the blood and dialysing fluid on either side of a semi-permeable membrane to effect the removal of toxic metabolites and excess water
  5. 5. How Hemodialysis Works?
  6. 6. Hemodialysis: Functions Cleanses the blood of accumulated waste products Removes the by-products of protein metabolism (urea, creatinine & uric acid) Removes excessive fluids Maintains or restores the buffer system of the body Maintains or restores electrolyte levels
  7. 7. Hemodialysis: AccessSubclavian and femoral catheterExternal arteriovenous shuntInternal arteriovenous fistualInternal arteriovenous graft
  8. 8. Subclavian (vein) Catheter…  may be inserted for short term or temporary use in acute renal failure  usually filled w/ heparin & capped to maintain patency between dialysis treatments  may be left in place for up to 6 wks if complications do not occur
  9. 9. Femoral (vein) Catheter…  may be inserted for short term or temporary use in acute renal failure  client should not sit up more than 45° or lean forward, or the catheter may kink & occlude.  an IV infusion pump w/ microdrip tubing should be used if a heparin infusion through the catheter is prescribed
  10. 10. External AV ShuntAccess is formed by the surgical insertion of 2 silastic cannulas into an artery or vein in the forearm or leg to form an external blood path.
  11. 11. External AV Shunt… Advantages Disadvantages can be used  external danger ofimmediately after disconnecting orinsertion dislodging the shunt no venipuncture  risk of hemorrhage,necessary for dialysis infection or clotting  skin erosion around the catheter site
  12. 12. Internal AV Fistula for chronic dialysis clients created surgically by anastomosis of a large artery & a large vein in the arm Maturity: veins become engorged due to the flow of arterial blood into the venous system; takes 1-2 wks. Maturity is required before the fistula can be used
  13. 13. Internal AV Fistula… Advantages Disadvantages less danger of clotting  cannot be usedand bleeding immediately after insertion  venipuncture is required can be used for dialysisindefinitely  infiltration of needles → decreased incidence hematomaof infection  aneurysm in the fistula no external dressing  Arterial steal syndromerequired
  14. 14. Internal AV Graft for chronic dialysis clients who do not have adequate blood vessels for the creation of a fistula Gore-Tex or a bovine (cow) carotid artery as artificial vein for blood flow Procedure involves the anastomosis of the graft to the artery, a tunneling under the skin, and anastomosis to a vein. can be used 2 wks after insertion Complications: clotting, aneurysms and infection
  15. 15. Internal AV Graft… Advantages Disadvantages less danger of clotting  cannot be usedand bleeding immediately after insertion  venipuncture is required can be used for dialysisindefinitely  infiltration of needles → decreased incidence hematomaof infection  aneurysm in the fistula no external dressing  Arterial steal syndromerequired
  16. 16. How long do hemodialysis treatments last?Usually, each hemodialysis treatment lasts about four hoursand is done three times per week.

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